“打孔栽桩”技术在股骨近端防旋髓内钉螺旋刀片取出滑丝时的应用  

Application of"drilling and planting piles"technology in pulling slip wire with PFNA spiral blade

作　　者：韩晓亮 王小龙 李富 孙志鹏 HAN Xiao-liang;WANG Xiao-long;LI Fu;SUN Zhi-peng(Orthopaedics Department 1,Dingxi People's Hospital;Department of Internal Medicine,The Second People's Hospital of Dingxi,Dingxi,Gansu 743000)

机构地区：[1]定西市人民医院骨一科 [2]定西市第二人民医院内科,甘肃定西743000

出　　处：《赣南医学院学报》2023年第11期1114-1117,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：定西市科技局重点技术攻关专项课题(DX2023BZ33)。

摘　　要：目的:总结应用“打孔栽桩”技术解决股骨近端防旋髓内钉(Proximal femoral nail antirotation,PFNA)螺旋刀片取出滑丝时的临床效果。方法:回顾性分析2015年1月—2023年1月于定西市人民医院骨科行股骨粗隆间骨折PFNA内固定取出术258例患者临床资料,其中发生螺旋刀片滑丝采用“打孔栽桩”技术取出者35例,设为打孔组。选取以常规术式取出螺旋刀片滑丝者35例,设为常规组。比较两组手术时间、打磨时间、术中出血量等指标。结果:打孔组手术时间[(65.12±7.16)min]、打磨时间[(26.25±5.12)min]短于常规组[(115.51±16.09)min、(70.91±6.95)min],差异有统计学意义(t=-16.96,P<0.05;t=-30.56,P<0.05);术中出血量[(71.23±9.97)mL]少于对照组[(116.08±18.81)mL](t=-12.47,P<0.05);两组术中均无医源性骨折、血管及神经损伤发生。常规组术后切口感染2例,后经换药后愈合,4例患者存在伤口周围少量金属碎屑残留,两组术后X线片复查内固定物全部取出。结论:PFNA螺旋刀片尾端出现滑丝时可选择“打孔栽桩”技术取出,是一种方便、快捷、安全的取出方法。Objective:To summarize the clinical effect of using the technique of"drilling and planting piles"to solve the problem of taking out the sliding wire with the spiral blade of proximal femoral nail(PFNA).Methods:From January 2015 to January 2023,a total of 258 cases of intertrochanteric fracture of femur were treated with PFNA internal fixation in our hospital,among which 35 cases were taken out by"drilling and planting piles"technique,which was designated as the perforation group.And another 35 patients were also selected to take out spiral blades by routine operation,and they were designated as the routine group.The operative time,polishing time and intraoperative blood loss were compared between the two groups.Results:The operation time of drilling group was(65.12±7.16)min,the grinding time was(26.25±5.12)min,shorter than thsoe of the routine group[(115.51±16.09)min、(70.91±6.95)min],with statistical significance(t=-16.96,P<0.05;t=-30.56,P<.05);The intraoperative blood loss was(71.23±9.97)mL,less than that of the routine group[(116.08±18.81)mL](t=-12.47,P<0.05).There were no iatrogenic fractures,vascular and nerve injuries in the two groups.There were 2 cases with postoperative incision infection in the routine group,and they were cured after dressing change;4 cases had residual metal debrits around the wounds,and they were taken out after X-ray reexamination in both groups.Conclusion:When the tail end of PFNA spiral blade is slippery,the technology of"drilling and planting piles"can be selected to take them out.It is convenient,fast and safe.

关 键 词：打孔栽桩 股骨近端防旋髓内钉 螺旋刀片 滑丝 

分 类 号：R683.4[医药卫生—骨科学]