激光辅助定位在老年股骨粗隆间骨折治疗中的应用效果分析  

Analysis of the Effect of Laser-assisted Positioning in the Treatment of Intertrochanteric Fractures of the Femur in the Elderly

作　　者：叶鸿风[1] 张振兴[1] 詹志川[1] 姜景尧 丘天雄 周志明[1] YE Hongfeng;ZHANG Zhenxing;ZHAN Zhichuan;JIANG Jingyao;QIU Tianxiong;ZHOU Zhiming(Department of Traumatology and Orthopaedics,Longyan Second Hospital,Longyan,Fujian Province,364000 China)

机构地区：[1]福建省龙岩市第二医院创伤关节骨病科,福建龙岩364000

出　　处：《中外医疗》2023年第17期54-57,共4页China & Foreign Medical Treatment

基　　金：龙岩市科技计划项目(2019LYF5014)。

摘　　要：目的探讨激光辅助定位治疗老年股骨粗隆间骨折的效果。方法随机选择2020年2月—2022年2月龙岩市第二医院70例老年股骨粗隆间骨折患者为研究对象,随机均分为观察组和对照组,每组35例。两组均给予闭合复位股骨近端防旋髓内钉内固定术,其中对照组给予传统透视辅助治疗,观察组给予激光辅助定位治疗。对比两组术中手术情况、导针调整次数、一次性导针置入成功率及术后影像学指标测定情况。结果两组术中出血量、TAD(<25 mm)情况对比差异无统计学意义(P>0.05);观察组手术时间短于对照组,透视次数、调整导针次数低于对照组,股骨头颈轴线夹角优于对照组,差异有统计学意义(P<0.05)。观察组一次性导针置入成功率45.71%明显高于对照组的14.29%,差异有统计学意义(χ^(2)=8.237,P=0.004)。结论激光辅助定位股骨近端防旋髓内钉内固定治疗老年股骨粗隆间骨折,能明显缩短手术操作时间,更精准定位头颈导针的位置,于更佳位置置入螺旋刀片,同时减少术中透视次数。Objective To explore the effect of laser-assisted positioning in the treatment of intertrochanteric fractures of the femur in the elderly.Methods From February 2020 to February 2022,70 elderly patients with intertrochanteric fracture of femur in the Second Hospital of Longyan City were randomly selected as the research objects and randomly divided into observation group and control group,with 35 cases in each group.Both groups were given closed reduction and proximal femoral anti-rotation intramedullary nail internal fixation.The control group was given traditional fluoroscopy-assisted treatment,and the observation group was given laser-assisted positioning treatment.The intraoperative operation,the number of guide needle adjustment,the success rate of one-time guide needle placement and the determination of postoperative imaging indexes were compared between the two groups.Results There was no statistically significant difference in intraoperative bleeding volume and TAD(<25 mm)between the two groups(P>0.05).The observation group had shorter surgical time than the control group,lower number of fluoroscopy and needle adjustment,and better angle between the femoral head and neck axis compared to the control group,and the difference was statistically significant(P<0.05).The success rate of one-time guide needle insertion was 45.71%in the observation group,which was significantly higher than the control group's 14.29%,and the difference was statistically significant(χ^(2)=8.237,P=0.004).Conclusion Laser-assisted positioning of proximal femoral nail antirotation internal fixation for the treatment of intertrochanteric fractures of the femur in the elderly can significantly shorten the operation time,more accurately position the head and neck guide pins,and better position the helical blade placement,while reducing the number of intraoperative fluoroscopic views.

关 键 词：老年 股骨粗隆间骨折 PFNA内固定 传统C臂机透视 激光辅助定位 

分 类 号：R4[医药卫生—临床医学]