两种不同放置外固定支架近端螺钉治疗老年股骨转子间骨折的疗效对比  

Evaluation of the effect of external fixator on intertrochanteric fracture in Baotou older patients

作　　者：李录军 李志远[1] 郭培刚[1] LI Lujun;LI Zhiyuan;GUO Peigang(Department of Orthopedics, Central Hospital of Baotou, Baotou 014040, Inner Mongolia, China)

机构地区：[1]包头市中心医院骨科,内蒙古包头014040

出　　处：《西部医学》2021年第8期1212-1214,1219,共4页Medical Journal of West China

基　　金：包头市中心医院博士启动科研项目(20180521)。

摘　　要：目的利用ORTHOFIX粗隆外固定支架治疗老年股骨粗隆间骨折患者时,近端螺钉两种不同放置对手术及疗效的影响。方法选取2015年1月~2018年12月我院收治的低能量创伤所致股骨粗隆间骨折且接受手术治疗的70例老年患者为研究对象,按照近心端螺钉放置方式分为A组(近端螺钉为收敛插入式),B组(近端螺钉为平行插入式),每组35例。结果A、B两组术中平均辐射暴露时间分别为15、16 s,差异有统计学意义(P<0.05),而手术时间、术中出血量以及平均骨折愈合时间无显著差异(P>0.05)。术后180 d,A组Harris髋关节评分优良率为94.28%,B组中Harris评分优良率为91.42%,两组无显著性差异(P>0.05)。两组术后并发症发生率相比,差异无统计学意义(P>0.05)。结论近端螺钉平行插入放置相对于收敛式放置更简易可行,更有效减少辐射暴露;无论近端螺钉平行或收敛插入的方式,对最终的手术结果并无明显影响。Objective To compare two different techniques of proximal pin placement for the treatment of intertrochanteric fractures in elderly patients utilizing the orthofix pertrochanteric fixator.Methods From January 2015 to December 2018,70 elderly patients with intertrochanteric fracture caused by low-energy trauma who received surgical treatment in our hospital were selected as the research objects.According to the placement method of proximal screw,they were divided into group A(proximal screw is convergent insertion type)and group B(proximal screw is horizontal insertion type),with 35 cases in each group.Results The mean radiographic exposure during pin insertion in Group A and Group B was 15 and 6 seconds,respectively(P<0.05).At 180 days after surgery,the excellent rate of Harris Hip Score in group A and group B were 94.28%and 91.42%(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Compared with the convergent placement,the parallel placement of proximal screw is more simple and feasible,which can effectively reduce radiation exposure.In addition,the way of parallel or convergent insertion of the proximal screw had no significant effect on the final surgical outcome.

关 键 词：股骨转子骨折 外固定 收敛插入式 平行插入式 Harris髋关节评分 老年 

分 类 号：R681.6[医药卫生—骨科学]