股骨重建髓内钉治疗股骨转子下骨折的疗效  

The effect of femoral reconstructive intramedullary nail in treatment of femoral subtrochanteric fracture

作　　者：舒本超 沈师 许玉林 李洋 叶俊武 卓乃强 SHU Ben-chao;SHEN Shi;XU Yu-lin;LI Yang;YE Jun-wu;ZHUO Nai-qiang(Dept of Bone and Joint,the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院骨与关节外科,四川泸州646000

出　　处：《临床骨科杂志》2023年第2期265-269,共5页Journal of Clinical Orthopaedics

基　　金：四川省泸州市人民政府-西南医科大学科技战略合作项目(编号:2020LZXNYDJ06)。

摘　　要：目的 探讨股骨重建髓内钉治疗股骨转子下骨折的疗效。方法 采用股骨重建髓内钉治疗42例股骨转子下骨折患者。记录手术情况、骨折愈合情况、术后并发症发生情况,末次随访时采用髋关节功能Harris评分、膝关节功能HSS评分评价疗效。结果 患者均获得随访,时间15~20个月。手术时间44~91(68.88±13.28)min,术中出血量40~120(83.21±17.42)ml,术后住院时间3~8(5.31±1.16)d。38例骨折愈合时间为3~6(4.03±0.72)个月,2例骨折在术后第10、11个月愈合,2例骨折不愈合经再次手术后愈合。术后切口感染2例,中重度贫血(血红蛋白<70 g/L)4例,螺钉退钉切出2例,髋内翻畸形1例,压疮2例。末次随访时,髋关节功能Harris评分为78~97(93.86±3.14)分,其中优39例,良1例,可2例,优良率为95.24%;膝关节功能HSS评分为91~97(94.69±1.52)分,42例均为优。结论 股骨重建髓内钉是治疗股骨转子下骨折良好的内固定方式,尤其适用于中青年患者。Objective To investigate the effect of femoral reconstruction intramedullary nail in treatment of subtrochanteric fracture of femur.Methods Forty-two patients with femoal subtrochanteric fractures were treated with femoral reconstructive intramedullary nail.The operation condition,fracture healing and postoperative complications were recorded.At the last follow-up,Harris score of hip joint function and HSS scores of knee joint function were used to evaluate the efficacy.Results All patients were followed up for 15~20 months.The operative time was 44~91(68.88±13.28)min,the intraoperative blood loss was 40~120(83.21±17.42)ml,and the postoperative hospital stay was 3~8(5.31±1.16)d.The healing time of 38 cases was 3~6(4.03±0.72)months,2 cases healed at 10,11 months after operation;2 cases had nonunion,and healed after re-operation.There were 2 cases of postoperative incision infection,4 cases of moderate-severe anemia(hemoglobin value<70 g/L),and 2 cases with screw withdrawal,hip varus deformity in 1 case,pressure ulcers in 2 cases.At the last follow-up,the Harris scores of hip function were 78~97(93.86±3.14)points,of which 39 cases were excellent,1 case was good,2 cases fair,with a excellent-good rate of 95.24%.The HSS of knee function scores were 91~97(94.69±1.52)points,and all 42 cases were excellent.Conclusions Femoral reconstructive intramedullary nail is a good internal fixation method for treatment of subtrochanteric fracture of femur,especially for young and middle-aged patients.

关 键 词：股骨转子下骨折 股骨重建髓内钉 股骨近端骨折 髓内固定 中青年 

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