钛缆辅助固定结合加长Gamma钉治疗股骨转子下骨折的临床疗效  

Clinical effect of titanium cable assisted fixation combined with lengthened Gamma nail in the treatment of subtrochanteric fracture of femur

作　　者：万全增 付宝光 WAN Quan-zeng;FU Bao-guang(Traditional Chinese Medical Hospital of Jining,Jining 272000,Shandong,China)

机构地区：[1]济宁市中医院骨伤科,山东济宁272000

出　　处：《中国骨伤》2020年第11期1058-1062,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨钛缆辅助固定结合加长Gamma钉治疗股骨转子下骨折的临床疗效。方法:回顾分析2010年1月至2018年1月收治的45例股骨转子下长段骨折患者资料,根据手术方案分为两组,采用钛缆辅助固定结合加长Gamma钉(观察组)24例,男14例,女10例,年龄(54.2±12.8)岁;单纯加长Gamma钉固定(对照组)21例,男12例,女9例,年龄(51.4±15.9)岁。观察并记录两组患者手术时间、术中失血量、住院天数、血红蛋白下降量以及骨折愈合时间,术后采用Harris髋关节功能评分进行疗效评价,观察并发症的发生情况。结果:所有患者获得随访,时间14~36个月。两组手术时间、术中失血量、住院天数比较差异有统计学意义(P<0.05)。观察组术后3个月骨折愈合率为79.1%(19/24),高于对照组的52.4%(11/21)(P<0.05)。两组术后1年Harris髋关节功能评分,术后6、12个月的骨折愈合率比较差异均无统计学意义(P>0.05)。两组无深部感染、内固定断裂及下肢深静脉血栓等并发症发生,对照组1例出现延迟愈合。结论:加长Gamma钉治疗股骨转子下骨折固定可靠,有限切开钛缆辅助固定可提高长段骨折复位率和固定强度,有利于早期功能锻炼。Objective:To investigate the clinical effect of titanium cable assisted fixation combined with lengthened Gamma nail in the treatment of subtrochanteric fracture of femur.Methods:From January 2010 to January 2018,45 patients with long subtrochanteric fractures were retrospectively analyzed,and they were divided into two groups according to the operation plan.There were 24 cases of titanium cable assisted fixation combined with lengthened Gamma nail(observation group),including 14 males and 10 females,with an age of(54.2±12.8)years;21 patients(control group)were treated with simple lengthened Gamma nail(control group),including 12 males and 9 females,with an age of(51.4±15.9)years.The operation time,intraoperative blood loss,hospital stay,hemoglobin decrease and fracture healing time were observed and recorded in the two groups.Harris hip function score was used to evaluate the postoperative curative effect,and the occurrence of complications was observed.Results:All patients were followed up for 14 to 36 months.There was significant difference in operation time,intraoperative blood loss,hospital stay between two groups(P<0.05).Three months after operation,the fracture healing rate of the observation group was 79.1%(19/24),which was higher than that of the control group 52.4%(11/21)(P<0.05).There was no significant difference in Harris hip function score 1 year after operation and fracture healing rate at 6 and 12 months after operation between the two groups(P>0.05).There were no complications such as deep infection,fracture of internal fixation and deep vein thrombosis of lower limbs in the two groups,and delayed healing occurred in 1 case in the control group.Conclusion:Lengthened Gamma nail fixation is reliable in the treatment of subtrochanteric fracture.Limited incision titanium cable assisted fixation can improve the reduction rate and fixation strength of long segment fracture,which is conducive to early functional exercise.

关 键 词：股骨骨折 髋骨折 骨折固定术 内 

分 类 号：R687.32[医药卫生—骨科学]