骨膜剥离器经螺旋刀片切口撬拨法用于骨折近端向前移位的难复性股骨粗隆间骨折的临床研究  

Clinical study on the application of the periosteum stripper to pry open intertrochanteric fractures with proximal and forward displacement by spiral blade incision

作　　者：刘翔 黎细平 江平频 郭剑波 LIU Xiang;LI Xi-ping;JIANG Ping-pin;GUO Jian-bo(Department of Orthopedic Surgery,Xinyu Hospital of Traditional Chinese Medicine,Jiangxi Province,Xinyu338000,China)

机构地区：[1]江西省新余市中医院骨外科,江西新余338000

出　　处：《中国当代医药》2021年第2期74-76,共3页China Modern Medicine

基　　金：江西省新余市科技计划项目(20193090870)。

摘　　要：目的探讨骨膜剥离器经螺旋刀片切口撬拨法用于骨折近端向前移位的难复性股骨粗隆间骨折的效果。方法选取2018年1月~2020年1月新余市中医院收治的60例骨折近端向前移位的难复性股骨粗隆间骨折患者作为研究对象,采用随机单双数法分为对照组(30例)和观察组(30例),对照组采用经牵引床闭合牵引复位后PFNA手术内固定方法,观察组采用骨膜剥离器经螺旋刀片切口撬拨法复位后行PFNA手术内固定方法。比较两组的手术时间、术中出血量、术后功能、关节活动度、疼痛评分、并发症总发生率。结果两组的手术时间和术中出血量比较,差异无统计学意义(P>0.05);两组的术后功能、关节活动度和疼痛等评分比较,差异无统计学意义(P>0.05);两组的并发症总发生率比较,差异无统计学意义(P>0.05)。结论使用骨膜剥离器经螺旋刀片切口撬拨法是一种较好的手术思路,用于骨折近端向前移位的难复性股骨粗隆间骨折患者可达到较理想治疗效果,有临床应用价值。Objective To explore the effect of the periosteum stripper on the difficult intertrochanteric fracture of femur with proximal and forward displacement by means of a spiral blade incision.Methods A total of 60 cases of refractory intertrochanteric fracture with proximal displacement of fracture in Xinyu Hospital of Traditional Chinese Medicine from January 2018 to January 2020 were selected and randomly divided into control group(30 cases)and observation group(30 cases)by single and even number method.The control group was treated with PFNA internal fixation after closed traction reduction by traction bed,and the observation group was treated with PFNA after periosteal stripper through spiral blade incision prying reduction methods of internal fixation.The operation time,intraoperative blood loss,postoperative function,joint range of motion,pain score and complication rate were compared between the two groups.Results There were no significant differences in operation time and intraoperative blood loss between the two groups(P>0.05).There were no significant differences in postoperative function,range of motion and pain between the two groups(P>0.05).There was no significant difference in the total complication rate between the two groups(P>0.05).Conclusion Using periosteal stripper through spiral blade incision prying is a good surgical idea.It can achieve ideal therapeutic effect for patients with refractory intertrochanteric fracture whose proximal fracture moves forward,and has clinical application value.

关 键 词：骨膜剥离器 螺旋刀片切口撬拨法 骨折近端 难复性股骨粗隆间骨折 

分 类 号：R687[医药卫生—骨科学]