小切口撬拨治疗嵌插难复性股骨转子间骨折  

Application of small incision to pry fracture reduction for the treatment of impacted and irreducible femoral intertrochanteric fracture

作　　者：肖奕增 黄东海 王清铿 赵枫[1] 尤瑞金 陈昆[1] Xiao Yizeng;Huang Donghai;Wang Qingkeng;Zhao Feng;You Ruijin;Chen Kun(Department of Orthopedics,The 910th Hospital of the Joint Logistics Support Force of the PLA,Quanzhou Fujian,362000,China)

机构地区：[1]中国人民解放军联勤保障部队第910医院骨科,福建泉州362000

出　　处：《生物骨科材料与临床研究》2023年第4期56-60,共5页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨应用小切口感触引导撬拨复位治疗嵌插难复性股骨转子间骨折的临床疗效。方法回顾性分析2017年3月至2021年10月中国人民解放军联勤保障部队第910医院手术治疗的26例嵌插难复性股骨转子间骨折患者资料,根据切开复位方式不同分为传统切开复位组(n=15)和小切口撬拨复位组(n=11)。比较两组的手术时间、术中显性失血量、术后前内侧皮质抵住对位率、骨折愈合时间和末次随访髋关节功能Harris评分。结果随访时间6~12个月,平均随访时间:小切口撬拨复位组8.7个月、传统切开复位组8.5个月。小切口撬拨复位组的手术时间和术中显性失血量均低于传统切开复位组,两组间比较差异有统计学意义(P<0.05);术后前内侧皮质抵住对位率和骨折愈合时间比较,差异无统计学意义(P>0.05);小切口撬拨复位组末次随访髋关节功能Harris评分高于传统切开复位组,差异有统计学意义(P<0.05)。结论小切口感触引导撬拨复位方法操作简单,手术时间短,术中出血少,关节功能恢复好,可应用于治疗嵌插难复性股骨转子间骨折。Objective To investigate the clinical efficacy of application of small incision for touch feeling to guide prying reduction in the treatment of impacted and irreducible femoral intertrochanteric fracture.Methods Clinical data of twenty-six patients with impacted and irreducible femoral intertrochanteric fracture were retrospectively analyzed from March 2017 to October 2021.Patients were divided into traditional open reduction group(n=15)and small incision pry reduction group(n=11)according to the open reduction method.The operation time,intraoperative obvious blood loss volume,support-resist ratio of antero-medial cortical postoperatively,fracture healing time and Harris hip function score at the last follow up were compared between the two groups.Results The follow-up time was 6 to 12 months,mean follow-up time:8.7 months in the small incision pry reduction group and 8.5 months in the traditional open reduction group.The operation time and intraoperative obvious blood loss in the small incision pry reduction group were lower than that in the traditional open reduction group,indicating the significant difference between the two groups(P<0.05).There was no significant difference of support-resist ratio of antero-medial cortical postoperatively and fracture healing time between the two groups(P>0.05).The Harris score of hip function in the last follow-up of the small incision pry reduction group was higher than that of the traditional open reduction group,showing the significant difference between the two groups(P<0.05).Conclusion The application of small incision for touch-feeling to guide prying reduction for the treatment of impacted and irreducible femoral intertrochanteric fracture has the advantages of easy handling,shorter operation time,lower intraoperative blood loss,and satisfactory recovery of joint function.

关 键 词：股骨转子间骨折 小切口 感触引导 撬拨复位 嵌插难复性 

分 类 号：R683.42[医药卫生—骨科学]