角度尺辅助下股骨近端防旋髓内钉固定治疗股骨转子间骨折  

Angle gauge used to assist internal fixation with proximal femoral nail antirotation for femoral intertrochanteric fracture

作　　者：武琳 曹鑫[1] 金鑫 杨震 张寿天 刘海涛[1] 崔华安 王远 孟险峰[1] Wu Lin;Cao Xin;Jin Xin;Yang Zhen;Zhang Shoutian;Liu Haitao;Cui Hua'an;Wang Yuan;Meng Xianfeng(Department of Orthopaedic Trauma,Central Hospital of Shengli Oilfield,Dongying,Shandong 257034,China)

机构地区：[1]胜利油田中心医院创伤骨科,东营市创伤骨科中心,山东省东营市257034

出　　处：《中华创伤骨科杂志》2020年第6期536-539,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨角度尺辅助下股骨近端防旋髓内钉(PFNA)固定治疗股骨转子间骨折的临床疗效。方法回顾性分析2016年2月至2018年8月期间采用PFNA固定治疗的54例股骨转子间骨折患者资料。根据是否辅助应用角度尺分为两组:试验组25例,男9例,女16例;年龄为(74.4±4.6)岁;骨折AO分型:31-A1型7例,31-A2型11例,31-A3型7例;采用角度尺辅助下PFNA固定。对照组29例,男9例,女20例;年龄为(74.4±3.9)岁;骨折AO分型:31-A1型9例,31-A2型16例,31-A3型4例;仅采用PFNA固定。比较两组患者的手术时间、前倾角矫正次数、术中X线透视次数及末次随访时髋关节Harris评分等。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。试验组患者的手术时间[(64.0±6.5)min]显著短于对照组患者[(72.7±3.9)min],前倾角矫正次数[(2.8±1.2)次]、X线透视次数[(7.0±1.2)次]显著少于对照组患者[(4.7±1.5)、(11.6±1.6)次],差异均有统计学意义(P<0.05)。54例患者术后获6~24个月(平均11个月)随访。末次随访时按髋关节Harris评分系统评定疗效:试验组优22例,良2例,可1例;对照组优23例,良4例,可1例,差1例,差异无统计学意义(P>0.05)。结论在PFNA固定治疗股骨转子间骨折术中,应用角度尺量化前倾角较不使用角度尺在缩短手术时间、减少前倾角矫正次数及X线透视次数方面有明显优势。Objective To evaluate the clinical application of an angle gauge in internal fixation with proximal femoral nail antirotation(PFNA)for femoral intertrochanteric fracture.Methods A retrospective analysis was carried out in the 54 elderly patients with intertrochanteric fracture of the femur who had been treated with PFNA internal fixation from February 2016 to August 2018 at Department of Orthopedic Trauma,Central Hospital of Shengli Oilfield.In the experimental group of 25 patients whose PFNA internal fixation was assisted by an angle gauge to measure the anteversion angle,there were 9 males and 16 females with an age of 74.4 years±4.6 years,and 7 cases of type 31-A1,11 cases of type 31-A2,and 7 cases of type 31-A3 by the AO classification;in the control group of 29 patients whose PFNA internal fixation was not assisted by an angle gauge,there were 9 males and 20 females with an age of 74.4 years±3.9 years,and 9 cases of type 31-A1,16 cases of type 31-A2,and 4 cases of type 31-A3 by the AO classification.The 2 groups were compared in terms of operation time,corrections of anteversion angle,intraoperative X-ray exposure times and Harris hip scores at the last follow-up.Results There were no significant differences between the 2 groups in their preoperative general data,indicating they were compatible(P>0.05).Compared with the control group,the experimental group showed significantly shorter operation time(64.0 min±6.5 min versus 72.7 min±3.9 min),significantly fewer corrections of anteversion angle(2.8±1.2 versus 4.7±1.5)and significantly fewer X-ray exposure times(7.0±1.2 versus 11.6±1.6)(all P<0.05).This cohort was followed up for 6 to 24 months(average,11 months).By the Harris hip scores at the last follow-up,therewere 22 excellent cases,2 good cases and one fair case in the experimental group,and 23 excellent cases,4 good cases and one poor case in the control group,showing an insignificant difference between the 2 groups(P>0.05).Conclusion Application of an angle gauge to assist PFNA internal fixation

关 键 词：髋骨折 骨折固定术 髓内 骨钉 角度尺 

分 类 号：R687.3[医药卫生—骨科学]