InterTan髓内钉内固定联合自体髂骨植骨治疗股骨粗隆间骨折钉板系统内固定失败的可行性和疗效  

Feasibility and efficacy of InterTan intramedullary nail internal fixation combined with autologous iliac bone grafting in the treatment of femoral intertrochanteric fractures with nail plate system failure

作　　者：马存义[1] 翟云 王建红 MA Cun-yi;ZHAI Yun;WANG Jian-hong(Department of Traumatology,Guilin Hospital of Traditional Chinese Medicine,Guilin Guangxi 541002,China)

机构地区：[1]桂林市中医医院创伤科,广西桂林541002

出　　处：《临床和实验医学杂志》2022年第10期1078-1081,共4页Journal of Clinical and Experimental Medicine

基　　金：广西壮族自治区中医药管理局科研课题(编号:GZZC2020316)。

摘　　要：目的探究InterTan髓内钉内固定联合自体髂骨植骨治疗股骨粗隆间骨折钉板系统内固定失败的可行性和疗效。方法前瞻性选取2019年1月至2021年6月桂林市中医医院58例股骨粗隆间骨折钉板系统内固定失败患者作为研究对象,随机数字表分为两组,每组29例。观察组采用InterTan髓内钉内固定联合自体髂骨植骨治疗,对照组采用股骨近端防旋髓内钉(PFNA)联合自体髂骨植骨治疗。比较两组手术指标、手术前后疼痛评分(VAS)、髋关节功能评分(Harris评分),评估术后恢复优良率及并发症情况。结果两组患者手术时间、术中出血量、切口长度及住院时间比较,差异无统计学意义(P>0.05);观察组骨折愈合时间为(12.35±2.15)周,短于对照组(16.38±3.64)周,差异有统计学意义(P<0.05)。手术前,两组患者VAS、Harris评分比较,差异无统计学意义(P>0.05);手术后,观察组患者VAS评分为(2.58±0.17)分,低于对照组(4.08±0.21)分,Harris评分为(83.22±5.35)分,高于对照组(72.41±4.34)分,差异均有统计学意义(P<0.05)。观察组术后恢复优良率为93.10%,高于对照组的68.97%,差异有统计学意义(P<0.05)。观察组并发症发生率为6.90%,低于对照组的27.59%,差异有统计学意义(P<0.05)。结论InterTan髓内钉内固定联合自体髂骨植骨应用于股骨粗隆间骨折钉板系统内固定失败患者,有利于促进骨折愈合,缓解疼痛,提升髋关节功能,减少并发症的发生,值得临床推广应用。Objective To explore the feasibility and efficacy of InterTan intramedullary nail internal fixation combined with autologous iliac bone grafting in the treatment of femoral intertrochanteric fractures with nail plate system failure.Methods From January 2019 to June 2021,58 patients with femoral intertrochanteric fractures in Guilin Hospital of Traditional Chinese Medicine who failed internal fixation with the nail plate system were prospectively selected as the research subjects,and randomly divided into two group,29 cases in each group.The observation group was treated with InterTan intramedullary nailing combined with autologous iliac bone graft,and the control group was treated with proximal femoral nail antirotation(PFNA)combined with autologous iliac bone graft.The surgical indicators,pre-and post-operative visual analogue scale(VAS),and hip joint function score(Harris score)were compared between the two groups,the postoperative recovery rate was evaluated,and the postoperative complication rate was followed up.Results There was no significant difference in operation time,intraoperative blood loss,incision length and hospital stay between the two groups(P>0.05);the fracture healing time of the observation group was(12.35±2.15)weeks,which was shorter than that of the control group[(16.38±3.64)weeks],and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference in VAS and Harris scores between the two groups(P>0.05).After surgery,the VAS score of the observation group was(2.58±0.17)points,which was lower than that of the control group[(4.08±0.21)points],and the Harris score was(83.22±5.35)points,which was higher than that of the control group[(72.41±4.34)points],the differences were statistically significant(P<0.05).The excellent and good rate of postoperative recovery in the observation group was 93.10%,which was higher than that in the control group(68.97%),and the difference was statistically significant(P<0.05).The incidence of complications in the observ

关 键 词：股骨粗隆间 骨折钉板系统内固定失败 InterTan髓内钉内固定 自体髂骨植骨 Harris评分 并发症 

分 类 号：R687.3[医药卫生—骨科学]