徒手牵引侧卧位与仰卧位股骨近端防旋髓内钉治疗股骨转子间骨折  

Lateral decubitus versus supine position by manual traction in treatment of intertrochanteric fractures with proximal femoral nail antirotation

作　　者：陈浩[1] 贺增良 李翔[2] 宋李军[2] 秦晓东[2] 陈群[2] 吕天润[2] 方加虎[2] CHEN Hao;HE Zeng-liang;LI Xiang;SONG Li-jun;QIN Xiao-dong;CHEN Qun;LV Tian-run;FANG Jia-hu(Dept of Orthopaedics,the Second Hospital of Nanjing,Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210003,China;Dept of Orthopaedics,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京中医药大学附属南京医院(南京市第二医院)骨科,江苏南京210003 [2]南京医科大学第一附属医院骨科,江苏南京210029

出　　处：《临床骨科杂志》2019年第5期593-595,共3页Journal of Clinical Orthopaedics

摘　　要：目的 比较徒手牵引侧卧位与仰卧位股骨近端防旋髓内钉(PFNA)固定治疗股骨转子间骨折的疗效。方法将58例采用PFNA固定治疗的股骨转子间骨折患者根据手术体位不同分为侧卧位组(31例)和仰卧位组(27例)。比较两组患者大转子顶端切口长度、手术时间、术中出血量、复位质量、住院时间、开始负重时间、骨折愈合时间及髋关节Harris评分。结果58例患者均获得随访,时间9~24个月。与仰卧位组相比,侧卧位组大转子顶端切口短、手术时间短,术中出血量少,差异均有统计学意义(P<0.05)。两组患者复位质量、住院时间、开始负重时间、骨折愈合时间及髋关节Harris评分比较差异均无统计学意义(P>0.05)。结论徒手牵引侧卧位行PFNA固定治疗股骨转子间骨折较仰卧位切口短、手术时间短、术中出血量少。Objective To compare the effect of the lateral decubitus and supine position by manual traction in the treatment of femoral intertrochanterie fractures with femoral proximal nail antirotation(PFNA). Methods The 58 patients with intertrochanteric fracture were treated with PFNA.The patients were divided into lateral decubitus position group(31 cases)and supine position group(27 cases)according to the surgical position.The two groups were compared in terms of incision length of the tip of greater trochanter,operation time,intraoperative bleeding volume, quality of fracture reduction,hospital stay, the time of weight loading,fracture healing time, and Harris score of the hip joint. Results All 58 patients were followed up for 9~24 months.Compared with the supine position group, the lateral position group had shorter incision,shorter operation time,and less intraoperative bleeding volume,the differences were significant ( P< 0.05).However,there were no significant differences in hospital stay,the time of weight loading,fracture healing time, and Harris score of the hip joint between the two groups ( P> 0.05). Conclusions In the treatment of femoral intertrochanterie fractures with PFNA by manual traction,lateral decubitus position may be associated with shorter incision,shorter operation time,and less intraoperative bleeding volume.

关 键 词：手术体位 徒手牵引 股骨转子间骨折 股骨近端防旋髓内钉 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]