不同内固定方式治疗股骨近端良性骨肿瘤伴病理性骨折的疗效对比  

Comparison of the efficacy of different internal fixation methods in the treatment of benign bone tumors with pathological fractures in the proximal femur

作　　者：宗刚[1] 孙爱敏[1] 应凯[1] 王文辉[1] 丁晓蕾[2] ZONG Gang;SUN Ai-min;YING Kai(Dalian Second People's Hospital,Dalian 116001,China)

机构地区：[1]大连市第二人民医院,116001 [2]大连医科大学附属二院,116000

出　　处：《中国现代药物应用》2022年第9期50-52,共3页Chinese Journal of Modern Drug Application

摘　　要：目的分析不同内固定方式治疗股骨近端良性骨肿瘤伴病理性骨折的疗效。方法60例股骨近端良性骨肿瘤伴病理性骨折患者,按照不同内固定方式分为对照组和观察组,每组30例。对照组采用动力髋螺钉内固定治疗,观察组采用股骨近端防旋髓内钉内固定治疗。比较两组患者手术时间、术中出血量、隐性失血量、负重时间、骨折愈合时间、国际骨与软组织肿瘤协会(MSTS)评分及并发症发生情况。结果观察组患者手术时间长于对照组,术中出血量、隐性失血量均多于对照组,差异具有统计学意义(P<0.05)。观察组患者负重时间、骨折愈合时间分别为(12.34±4.12)周、(9.78±2.26)个月,均短于对照组的(17.04±4.05)周、(13.46±3.02)个月,差异具有统计学意义(P<0.05);观察组和对照组患者MSTS评分分别为(26.34±2.12)、(25.52±1.63)分,比较差异无统计学意义(P>0.05)。观察组患者并发症发生率3.33%低于对照组的20.00%,差异具有统计学意义(P<0.05)。结论股骨近端防旋髓内钉内固定治疗股骨近端良性骨肿瘤伴病理性骨折能够缩短骨折愈合时间,且并发症较少,而动力髋螺钉内固定手术时间短,出血量少,负重时间长,临床应根据患者实际情况采取正确的治疗手段。Objective To analyze the efficacy of different internal fixation methods in the treatment of benign bone tumors with pathological fractures in the proximal femur.Methods A total of 60 patients with benign bone tumors and pathological fractures of the proximal femur were divided into control group and observation group according to different internal fixation methods,with 30 cases in each group.The control group was treated with dynamic hip screw internal fixation,and the observation group was treated with proximal femoral nail anti-rotation internal fixation.Both groups were compared in terms of operation time,intraoperative blood loss,occult blood loss,weight-bearing time,fracture healing time,Musculoskeletal Tumor Society(MSTS)score and complications.Results The operation time of the observation group was longer than that of the control group,and the intraoperative blood loss and occult blood loss were more than those of the control group.All the differences were statistically significant(P<0.05).The weight-bearing time and fracture healing time of the observation group were(12.34±4.12)weeks and(9.78±2.26)months,which were shorter than(17.04±4.05)weeks and(13.46±3.02)months of the control group,and the differences were statistically significant(P<0.05).The MSTS scores of the observation group and control group were(26.34±2.12)and(25.52±1.63)points,and the difference was not statistically significant between the two groups(P>0.05).The complication rates 3.33%in the observation group were lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Proximal femoral nail anti-rotation internal fixation in the treatment of benign bone tumors and pathological fractures of the proximal femur can shorten the fracture healing time and have fewer complications,while dynamic hip screw internal fixation has a shorter operation time,less blood loss,and longer weight-bearing time.The correct treatment method should be taken according to the actual situation of the patient.

关 键 词：股骨近端良性骨肿瘤 病理性骨折 动力髋螺钉内固定 股骨近端防旋髓内钉内固定 

分 类 号：R687.3[医药卫生—骨科学]