无牵引床平卧位辅以DAA 入路小切口治疗难复性股骨转子间骨折的价值  

Supine position combined with DAA approach without use of traction bed for refractory femoral intertrochanteric fractures

作　　者：代秀松[1] 赵志[1] 官建中[1] 王晓盼[1] 陈笑天[1] 吴敏[1] DAI Xiusong;ZHAO Zhi;GUAN Jianzhong;WANG Xiaopan;CHEN Xiaotian;WU Min(Department of Orthopedics,Laboratory of Tissue and Transplant in Anhui Province,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院骨科,组织移植安徽省重点实验室,安徽蚌埠233004

出　　处：《皖南医学院学报》2022年第5期444-447,共4页Journal of Wannan Medical College

基　　金：安徽省教育厅高校自然科学研究重点项目(SK2018A1077)。

摘　　要：目的:探究无牵引床平卧位辅以DAA入路小切口治疗难复性股骨转子间骨折的临床效果。方法:回顾性分析30例在我院进行手术治疗的难复性股骨转子间骨折患者资料,15例采用无牵引床下平卧位DAA入路小切口方法(无牵引床组),15例采用牵引床下平卧位辅以牵引、撬拨方式(牵引床组)。观察并比较两组间的术前准备时间、手术时间、透视次数、术中出血量、复位效果、术后Harris评分及术后至完全负重行走时间发生情况。结果:无牵引床组术前准备时间和手术时间均短于有牵引床组(P<0.001);无牵引床组术中透视次数小于有牵引床组(P<0.01)。两组患者术后12个月髋关节功能评分均分别较术后6个月升高(P<0.001),但两组术后12个月髋关节功能评分上升幅度差异无统计学意义(P>0.05)。两组患者在住院期间均未出现感染等并发症。结论:无牵引床平卧位辅以DAA入路小切口治疗难复性股骨转子间骨折的临床效果较好,无需使用牵引床且易于术者学习和掌握,并可以节省术前准备时间和手术时间,减少透视次数,有利于在基层医院广泛推广应用。Objective:To evaluate the clinical effect of direct anterior approach(DAA)via small incision combined with supine position without use of traction bed for the treatment of refractory femoral intertrochanteric fracture.Methods:Retrospective analysis was performed in 30 patients with refractory femoral intertrochanteric fracture undergone surgical treatment in our hospital.Fifteen patients were treated by DAA via small incision combined with supine position without use of traction bed(non-traction bed group),and another 15 were managed by supine position reduction assisted by traction bed plus pulley device(traction bed group).The two groups were observed and compared pertinent to preoperative preparation time,surgical duration,frequencies of X-ray exposure,intraoperative blood loss,reduction effect,postoperative Harris score,and the time at and length of complete weight-bearing walking after surgery.Results:Preoperative preparation time and surgical duration as well as intraoperative frequencies of X-ray exposure were shorter and lower in non-traction bed group than in traction bed group(P<0.01).The hip function scores of patients in both groups were increased significantly after surgery at 12 months compared to at 6 months(P<0.001),yet there was no statistical significance in the increase of hip function scores at 12 months after surgery between the two groups(P>0.05).No complications such as infection occurred in the two groups during hospitalization.Conclusion:The supine position without use of traction bed combined with DAA via small incision has a good clinical effect in the treatment of refractory femoral intertrochanteric fracture.This procedure is worthy of application in primary hospitals because it can be easily learnt and commanded by the surgeons,and reduce preoperative preparation and surgical time as well as frequencies of X-ray exposure.

关 键 词：牵引床 平卧位 DAA入路 难复性股骨转子间骨折 

分 类 号：R687.3[医药卫生—骨科学]