钛丝环扎固定外侧壁联合股骨近端防旋髓内钉治疗AO/OTA 31-A3型股骨转子间骨折的临床疗效  

Clinical outcome of fixing lateral wall with titanium-wire cerclage combined with proximal femoral nail antirotation in the treatment of AO/OTA 31-A3 femoral intertrochanteric fracture

作　　者：丁超 邹明[1] 马成才[1] 刘冰[1] 张琪琪 DING Chao;ZOU Ming;MA Cheng-cai;LIU Bing;ZHANG Qi-qi(Department of Orthopedics,People’s Hospital of Bozhou,Bozhou Anhui 236800,China)

机构地区：[1]亳州市人民医院骨科,安徽亳州236800

出　　处：《局解手术学杂志》2023年第3期245-248,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：安徽省科技计划项目(1704a0802170)。

摘　　要：目的探讨钛丝环扎固定外侧壁联合股骨近端防旋髓内钉治疗AO/OTA 31-A3型股骨转子间骨折的临床疗效。方法选取我院收治的AO/OTA31-A3型股骨转子间骨折患者20例,所有患者均行钛丝环扎固定外侧壁联合股骨近端防旋髓内钉治疗。记录患者手术时间、术中失血量及围术期并发症发生情况。术后X射线观察骨折愈合情况,术前及术后12个月采用视觉模拟量表(VAS)评估骨折部位疼痛情况,采用Harris评分评估髋关节功能。结果所有患者手术均顺利完成,手术时间平均(2.25±0.90)h;术中失血量平均(403.28±204.56)mL。术后12个月VAS评分为(1.03±0.54)分,低于术前的(7.35±1.32)分,差异有统计学意义(t=9.335,P<0.001)。术后12个月Harris评分为(88.65±5.89)分,高于术前的(38.20±7.42)分,差异有统计学意义(t=-24.320,P<0.001)。所有患者均未发生伤口感染及不愈合、关节周围神经血管损伤、内固定失败等并发症。结论使用钛丝环扎固定外侧壁联合股骨近端防旋髓内钉治疗AO/OTA 31-A3型股骨转子间骨折并发症较少,骨折断端对位良好,复位稳定,能促进骨折早期愈合,临床疗效满意。Objective To explore the clinical outcome of fixing lateral wall with titanium-wire cerclage combined with proximal femoral nail antirotation in the treatment of AO/OTA 31-A3 femoral intertrochanteric fracture.Methods A total of 20 patients with AO/OTA 31-A3 femoral intertrochanteric fracture treated in our hospital were selected,and all of them were treated with fixing lateral wall with titanium-wire cerclage combined with proximal femoral nail antirotation.The operation time,intraoperative blood loss and perioperative complications were recorded.The fracture healing after operation was observed by X-ray examination.The visual analogue scale(VAS)was used to evaluate the pain at the fracture site and Harris score was used to evaluate the hip function before operation and 12 months after operation.Results The operations of all patients were completed successfully,with an average operation time of(2.25±0.90)hours and an average intraoperative blood loss of(403.28±204.56)mL.The VAS score 12 months after operation was lower than that before operation(1.03±0.54 vs.7.35±1.32),with statistically significant difference(t=9.335,P<0.001).The Harris score 12 months after operation was higher than that before operation(88.65±5.89 vs.38.20±7.42),with statistically significant difference(t=-24.320,P<0.001).There was no wound infection or nonunion,peripheral nerve or vascular injury or internal fixation failure occurred in all patients.Conclusion Fixing lateral wall with titanium-wire cerclage combined with proximal femoral nail antirotation in the treatment of AO/OTA 31-A3 femoral intertrochanteric fracture has fewer complications,good alignment of fracture ends and stable reduction,which can promote the early healing of fracture with satisfactory clinical effect.

关 键 词：转子间骨折 钛丝 股骨近端防旋髓内钉 外侧壁 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]