波及股骨颈区域的股骨粗隆间骨折临床研究  

Clinical study of femoral intertrochanteric fractures affecting the femoral neck region

作　　者：韩晓军[1] 王艳彬[1] 刘志鹏[1] 马超[1] 陈祥云[1] 张文治[1] HAN Xiaojun;WANG Yanbin;LIU Zhipeng(Department of Orthopaedics,The Fourth People’s Hospital of Hengshui,Hebei Hengshui 053000)

机构地区：[1]河北省衡水市第四人民医院关节骨科,053000

出　　处：《河北医药》2021年第13期1976-1979,共4页Hebei Medical Journal

基　　金：衡水市科学技术研究与发展计划(编号:2017014013C-36)。

摘　　要：目的探讨应用空心螺钉辅助股骨近端防旋髓内钉(PFNA)对波及股骨颈区域的股骨粗隆间骨折的治疗效果。方法收集2016年1月至2019年12月诊治的股骨粗隆间骨折线波及股骨颈基底区域的骨折患者共212例,随机分成试验组和对照组,每组106例。2组手术均采用骨科牵引床完成,对照组行常规PFNA手术,试验组采用空心螺钉+PFNA。观察2组患者手术时间、术中出血量、骨折愈合时间和并发症情况,根据Harris评分评估术后3个月、6个月、12个月髋关节功能,测量术后6个月髋关节活动度。结果试验组患者手术时间明显长于对照组(P<0.05)。但是2组患者出血量差异无统计学意义(P>0.05),且试验组患者骨折愈合时间、术后卧床时间明显短于对照组(P<0.05)。试验组患者术后3个月、6个月、12个月Harris评分均明显优于对照组(P<0.05);试验组患者术后6个月髋关节活动度明显优于对照组(P<0.05);试验组患者并发症发生率明显低于对照组(P<0.05)。结论应用空心钉联合PFNA对骨折线波及股骨颈的股骨粗隆间骨折患者进行治疗,出血量无明显差异,缩短患者术后卧床时间和骨折愈合时间,提高患者Harris评分,降低各类并发症发生率,治疗效果明确,可以在临床推广应用。Objective To investigate the effect of proximal femoral nail antirotation(PFNA)assisted by hollow screw for the treatment of intertrochanteric fractures of femur affecting the femoral neck area.Methods A total of 212 cases of intertrochanteric fracture line of femur and fractures affecting the base of the femoral neck were collected from January 2016 to December 2019.They were randomly divided into experimental group and control group,with 106 cases in each group.Both groups were operated on the orthopedic traction bed.The control group was subjected to conventional PFNA surgery,and the experimental group used cannulated screws+PFNA.The operation time,intraoperative blood loss,fracture healing time and complications were observed in the two groups.Hip joint function was evaluated according to the Harris score at 3 months,6 months and 12 months,hip joint range of motion was measured at 6 months after operation.Results The operation time of the experimental group was significantly longer than that of the control group(P<0.05).However,the amount of bleeding between the two groups has no significant difference.What’s more,the fracture healing time and postoperative bed time was significantly shorter than that of the control group(P<0.05).The Harris scores of patients in the experimental group were significantly better than those in the parallel group at 3 months,6 months,and 12 months after surgery(P<0.05);the hip joint range of motion in the experimental group was significantly better at 6 months after surgery than that in the control group(P<0.05);the complication rate of the experimental group was significantly lower than that in the control group(P<0.05).Conclusion The use of hollow nails combined with PFNA to treat patients with femoral intertrochanteric fractures with fracture lines spreading to the femoral neck can reduce blood loss,significantly shorten the postoperative bed time and fracture healing time,improve the patient’s Harris score,and reduce various complications incidence and the treatment effec

关 键 词：股骨粗隆间骨折 股骨颈骨折 旋转稳定性 防旋股骨近端髓内钉 空心钉 

分 类 号：R683[医药卫生—骨科学]