股骨近端InterTan髓内钉及股骨近端抗旋髓内钉-Ⅱ在股骨转子下SeinsheimerⅤ型骨折患者中的应用效果  

Application effects of proximal femoral InterTan intramedullary nail and proximal femoral nail antirotationⅡin patients with SeinsheimerⅤsubtrochanteric femoral fractures

作　　者：郑义海 万文辉 ZHENG Yihai;WAN Wenhui(Department of Orthopedics,Jingdezhen Fourth People's Hospital,Jingdezhen,Jiangxi,333000,China)

机构地区：[1]景德镇市第四人民医院骨科,江西景德镇333000

出　　处：《当代医学》2024年第10期48-52,共5页Contemporary Medicine

摘　　要：目的探讨股骨近端InterTan髓内钉及股骨近端抗旋髓内钉-Ⅱ(PFNA-Ⅱ)在股骨转子下SeinsheimerⅤ型骨折患者中的应用效果。方法选取2022年1月至2023年12月景德镇市第四人民医院收治的80例SeinsheimerⅤ型骨折患者作为研究对象,随机分为观察组(n=41)与对照组(n=39)。对照组采用PFNA-Ⅱ治疗,观察组采用InterTan髓内钉治疗。比较两组手术指标、恢复情况、血清骨代谢指标{Ⅰ型前胶原氨基末端前肽(PINP)、Ⅰ型胶原交联羧基末端肽(CTX-I)、骨钙素(OC)、25-羟基维生素D_(3)[25-(OH)_(2)D_(3)]、甲状腺旁激素(PTH)}、凝血功能指标[凝血酶时间(TT)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、D-二聚体(D-D)]、血液流变学指标及并发症发生情况。结果观察组手术时间长于对照组,术中出血量大于对照组,骨折愈合时间、完全负重时间均短于对照组,差异有统计学意义(P<0.05);两组切口长度比较差异无统计学意义。两组恢复优良率比较差异无统计学意义。术后,两组PINP、CTX-I、OC、25-(OH)_(2)D_(3)、PTH水平均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。术后,两组TT、APTT、PT均短于术前,FIB、D-D水平均高于术前,且观察组TT、APTT、PT均短于对照组,FIB、D-D水平均高于对照组,差异有统计学意义(P<0.05)。术后,两组全血黏度、血浆黏度、红细胞比容、红细胞刚性指数均低于术前,红细胞变形指数均高于术前,且观察组全血黏度、血浆黏度、红细胞比容、红细胞刚性指数均低于对照组,红细胞变形指数高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为7.32%,低于对照组的30.77%,差异有统计学意义(P<0.05)。结论PFNA-Ⅱ、InterTan髓内钉治疗股骨转子下SeinsheimerⅤ型骨折效果相当,各具优势,前者手术时间短,操作简单,后者理论上具有更佳的稳定性及平衡骨代谢指标优势,可改�Objective To investigate the application effects of proximal femoral InterTan intramedullary nail and proximal femoral nail anti-rotationⅡ(PFNA-Ⅱ)in patients with Seinsheimer typeⅤsubtrochanteric femoral fractures.Methods A total of 80 patients with SeinsheimerⅤsubtrochanteric femoral fractures who were admitted to Jingdezhen Fourth People's Hospital from January 2022 to December 2023 were selected as the study subjects,they were randomly divided into the observation group(n=41)and the control group(n=39).The control group was treated with PFNA-Ⅱ,while the observation group was treated with InterTan intramedullary nail.The surgical indexes,recovery,serum bone metabolism indexes(N-terminal propeptide of typeⅠprocollagen(PⅠNP),typeⅠcollagen cross-linked C-terminal telopeptide(CTX-Ⅰ),osteocalcin(OC),25-hydroxyvitamin D_(3)(25-[OH]_(2)D_(3)),parathyroid hormone[PTH]),coagulation function indexes(thrombin time[TT],activated partial thrombin time[APTT],prothrombin time[PT],fibrinogen[FIB],D-dimer[D-D]),hemorheology indexes and complications were compared between the two groups.Results The operation time in the observation group was longer than that in the control group,the intraoperative blood loss was greater than that in the control group,and the fracture healing time and complete weight-bearing time were shorter than those in the control group,the differences were statistically significant(P<0.05);there was no significant difference in incision length between the two groups.There was no significant difference in the excellent and good rate of recovery between the two groups.After operation,the levels of PⅠNP,CTX-Ⅰ,OC,25-(OH)_(2)D_(3) and PTH of the two groups were higher than those before operation,and the observation group was higher than the control group,the differences were statistically significant(P<0.05).After operation,TT,APTT and PT of the two groups were shorter than those before operation,FIB and D-D levels were higher than those before operation,and TT,APTT and PT in the observation

关 键 词：股骨近端InterTan髓内钉 股骨近端抗旋髓内钉-Ⅱ 骨折固定术 股骨转子下SeinsheimerⅤ型骨折 

分 类 号：R687.3[医药卫生—骨科学]