闭合与有限切开髓内钉固定股骨转子下骨折比较  

Comparison of closed and limited-open intramedullary nails for femoral subtrochanteric fractures

作　　者：吴小松[1] 王庆伟 石华峰[1] 胡寿勇[1] 叶正云[1] 黄继锋 WU Xiao-song;WANG Qing-wei;SHI Hua-feng;HU Shou-yong;YE Zheng-yun;HUANG Ji-feng(Department of Orthopedics,Jingmen First Peopled Hospital,Jingmen 448000,China;Department of Orthopedics,General Hospital of the PLA Central Theater,Wuhan 430070,China)

机构地区：[1]荆门市第一人民医院骨科,湖北荆门448000 [2]中国人民解放军中部战区总医院骨科,湖北武汉430070

出　　处：《中国矫形外科杂志》2021年第20期1893-1896,共4页Orthopedic Journal of China

摘　　要：[目的]对比闭合与有限切开加长Inter TAN髓内钉治疗SeinsheimerV型股骨转子下骨折的临床疗效。[方法]回顾性分析2017年1月-2020年5月收治并采用加长InterTAN髓内钉内固定治疗Seinsheimer V型股骨转子下骨折患者42例(43髋)。其中,闭合复位固定15例(15髋),切开复位固定27例(28髋)。[结果]闭合组手术时间、术中出血量显著少于切开组,差异均有统计学意(P<0.05)。两组透视次数、住院时间、并发症发生率差异无统计学意义(P>0.05)。闭合组在开始负重时间及完全负重时间上均显著晚于切开组(P<0.05);两组末次随访时髋关节Harris功能评分、VAS腿痛评分差异均无统计学意义(P>0.05)。[结论]闭合与有限切开加长InterTAN髓内钉治疗SeinsheimerV型股骨转子下骨折均能获得较好效果,有限切开骨折复位好、固定可靠、恢复更快,为闭合复位困难时的不错选择。[Objective]To compare the clinical outcomes of closed versus limited-open lengthened InterTAN intramedullary nails for Seinsheimer type V femoral subtrochanteric fractures.[Methods]A retrospective study was conducted on 42 patients(43 hips)who underwent internal fixation of Seinsheimer type V femoral subtrochanteric fractures with lengthened InterTAN intramedullary nail from January 2017 to May 2020.Among them,15 patients(15 hips)were by the closed technique,while the remaining 27 patients(28 hips)had operation performed by the limited-open technique.[Results]The closed group proved significantly superior to the limited-open group in terms of operation time and intraoperative blood loss(P<0.05),nevertheless there were no statistically significant differences between the two groups in the number of fluoroscopies,hospital stay,and complication rate(P>0.05).The limited-open group resumed weight bearing and full weight bearing significantly earlier than the closed group(P<0.05).However,there were no significant differences in the Harris score and VAS score for leg pain between the two groups at the last follow-up(P>0.05).[Conclusion]Both closed and limited-open lengthened InterTAN intramedullary nails achieve satisfactory outcomes for Seinsheimer type V femoral subtrochanteric fractures.The limited-open technique get good fracture reduction,reliable fixation,and faster recovery,which is a good alternative when closed technique is difficult.

关 键 词：股骨转子下骨折 骨折固定术 髓内钉 

分 类 号：R683.42[医药卫生—骨科学]