正骨手法结合牵引床复位在股骨粗隆部骨折PFNA内固定术中的应用  

Application of orthopedic manipulation with traction bed reduction in PFNA internal fixation of trochanteric fractures of the femur

作　　者：陈夏平 吴天然 王瑞雄 张昭兴 敖庆芳 Chen Xiaping

机构地区：[1]福建省泉州市正骨医院,福建泉州362000

出　　处：《中医临床研究》2020年第16期48-52,共5页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨正骨手法结合牵引床复位在股骨粗隆部骨折股骨近端防旋髓内钉(Proximal Femoral Nail Antirotation,PFNA)内固定术中运用的有效性及闭合复位失败的应对策略。方法:总结分析2015年1月-2017年12月收治于我院的416例有明显移位的股骨粗隆部骨折应用PFNA内固定手术治疗的临床资料。结果:经过术中透视证实,正骨手法结合牵引床复位成功338例,再结合器械经皮闭合复位成功31例,闭合复位失败改经入钉口切口或PFNA刀片切口微创复位47例,正骨手法结合牵引床复位成功率为81.25%(338/416)。结论:利用正骨手法结合牵引床复位能有效闭合复位股骨粗隆部骨折,为微创手术PFNA内固定术治疗的顺利进行奠定了良好的基础,此方法操作简单,安全性及成功率高,值得临床推广应用。Objective:To investigate the effectiveness of orthopedic manipulation plus traction bed reduction on Proximal Femoral Nail Antirotation(PFNA)internal fixation and coping strategies for failure of closed reduction.Methods:The clinical data of 416 patients with markedly displaced femoral trochanteric fractures who were treated in our hospital from January 2015 to December 2017 were summarized and analyzed.Results:Through intraoperative fluoroscopy,338 cases were successfully reset with orthopedic manipulation with traction bed,and 31 cases were successfully reset with percutaneous closure.The failure of closed reduction was changed to a minimally invasive reduction with a staple incision or a PFNA blade incision.Combined with the traction bed,the success rate was 81.25%(338/416).Conclusion:The orthopedic technique plus traction bed reduction can effectively close and reduce the trochanteric fractures of the femur,laying a good foundation for the smooth progress of minimally invasive PFNA internal fixation.This method is simple,safe and successful,and is worthwhile clinical application.

关 键 词：正骨手法 牵引床复位 股骨粗隆部骨折 股骨近端髓内钉系统 临床分析 

分 类 号：R274.12[医药卫生—中医骨伤科学]