2种方法治疗Russell-TaylorⅡ 型股骨转子下骨折回顾性研究  

Retrospective Studies of Two Methods for Subtrochanteric Fractures of Type Russell-TaylorⅡ

作　　者：舒荣兵 吕仁发 邹澍 潘小峰 周江军 孙琦 吴刚 SHU Rong-Bing;LV Ren-Fa;ZOU Su(The People's liberation army of 908 hospital,Jangxi province 335000)

机构地区：[1]解放军第908医院,江西鹰潭335000

出　　处：《中国伤残医学》2020年第11期1-3,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:比较采用股骨近端带锁髓内钉与股骨近端外侧锁定钢板治疗Russell-TaylorⅡ型股骨转子下骨折的疗效.方法:自2014年4月-2017年4月分别使用股骨近端带锁髓内钉LPFP(PFNA组54例)和股骨近端外侧锁定钢板PFLP(PFLP组52例)治疗Russell-TaylorⅡ型股骨转子下骨折106例,比较2组患者的手术情况(手术时间、术中出血量、下地时间、骨折愈合时间)、术后患者疼痛情况、术后髋关节功能Harris评分、术后、并发症情况.结果:随访10-24个月,2组相比,PFNA组手术时间短,术中出血量及术后切口引流量少,疼痛评分低,PFNA组下地时间及骨折愈合时间更短,与LPFP组有统计学意义(P<0.05),按照Harris髋关节功能评分标准优良率,2组优良率无显著性差异(P<0.05).LPFP组术后并发症发生率明显高于PFNA组,尤其是远期并发症.结论:使用股骨近端带锁髓内钉与股骨近端外侧锁定钢板治疗Russell-TaylorⅡ型股骨转子下骨折,PF-NA内固定平均手术时间短,及术后切口引流量少,术中、术后并发症发生率低,骨折愈合时间短.PFNA对骨折端的血循环影响较小,近端扩髓时不会导致骨折断端分离,是治疗Russell-TaylorⅡ型股骨转子下骨折的合理手术方法.Objective:To compare the efficacy of proximal femoral interlocking intramedullary nail and proximal femoral locking plate in the treatment of Russell-Taylor Ⅱ femoral subtrochanteric fracture,and to explore the rational treatment of Russell-Taylor Ⅱ femoral subtrochanteric fracture.Methods:From April 2014 to April 2017,the proximal femoral interlocking intramedullary nail PFNA(54 cases in the PFNA group)and the proximal femoral locking plate PFLP(52 cases in the PFLP group)were used to treat the Russell-Taylor type Ⅱ femoral trochanter.The operation status(surgery time,intraoperative blood loss,time to ground,fracture healing time),postoper-ative pain,and postoperative hip function Harris score were compared between the two groups.Result:Followed up for 10 to 24 months,Compared with the two groups,the PFNA group had shorter operation time,less intraoperative blood loss and postoperative incision drain-age,lower pain score,shorter time in the PFNA group and shorter fracture healing time,and statistically significant difference with the PFLP group(P<0.05).According to the excellent rate of Harris hip function score,there was no significant difference between the two.groups(P<0.05).The incidence of postoperative complications in the PFLP group was significantly higher than in the PFNA group,es-pecially in the long-term complications.Conclusion:The proximal femoral interlocking nail and the proximal femoral locking plate were used to treat Russell-Taylor type Ⅱ subtrochanteric fracture.The average operative time of PFNA intemal fixation was short,and the postoperative incision drainage was less.Complications occurred during operation and postoperative complications.The rate is low and the fracture healing time is short.PFNA has lttle effect on the blood circulation of the fracture end,and the proximal reaming does not lead to the separation of the fracture end.It is a reasonable surgical method for the treatment of Russell-Taylor type Ⅱ femoral subtrochanteric fracture.

关 键 词：股骨转子下骨折 股骨近端外侧锁定钢板 股骨近端带锁髓内钉 骨折内固定术 

分 类 号：R683.42[医药卫生—骨科学]