前外侧小切口辅助复位InterTan髓内钉治疗高龄难复性股骨粗隆间骨折  

Anterolateral mini-incision assisted reduction with InterTan intramedullary nail in treating elderly refractory femoral intertrochanteric fractures

作　　者：梁建基 何智勇[1] 余新平[1] LIANG Jianji;HE Zhiyong;YU Xinping(First Department of Orthopedics,Zhongshan Municipal People’s Hospital,Zhongshan,Guangdong 528403,China)

机构地区：[1]中山市人民医院骨一科,广东中山528403

出　　处：《重庆医学》2024年第13期2000-2004,2010,共6页Chongqing medicine

基　　金：2023年度广东省中山市医学科研项目(20231A020017)。

摘　　要：目的 探讨前外侧小切口辅助复位InterTan髓内钉治疗高龄难复性股骨粗隆间骨折的临床疗效,为临床治疗提供参考依据。方法 选取2020年8月至2023年4月收治的58例高龄股骨粗隆间骨折患者为研究对象,根据手术方案分为观察组及对照组各29例。观察组采用前外侧小切口辅助复位InterTan髓内钉治疗,其中男6例、女23例,年龄80~102岁,平均(86.14±4.98)岁。对照组采用闭合复位InterTan髓内钉治疗,其中男8例、女21例,年龄80~99岁,平均(86.33±5.09)岁。比较两组患者术中出血量、住院时间、骨折相关并发症发生率、手术时间、术后骨折复位质量、术后内侧皮质支撑类型、术后髋关节Harris评分。结果 两组患者均获得随访,随访时间6~12个月,平均(11.45±1.59)个月。两组患者的术中出血量、住院时间、骨折相关并发症发生率差异无统计学意义(P>0.05)。观察组手术时间为(88.79±29.58)min,对照组为(70.66±24.47)min,两组比较差异有统计学意义(P<0.05);观察组骨折复位质量优良率为100%,对照组为75.86%,两组比较差异有统计学意义(P<0.05);观察组骨折内侧皮质支撑类型为正性支撑及中性支撑的比例为96.55%,对照组为72.41%,两组比较差异有统计学意义(P<0.05);观察组髋关节Harris评分为(76.33±12.71)分,对照组为(68.39±13.17)分,两组比较差异有统计学意义(P<0.05)。结论 高龄难复性股骨粗隆间骨折患者,常合并多种基础病,手术风险极高,利用前外侧小切口辅助复位InterTan髓内钉内固定手术治疗,不增加明显创伤前提下,能获得满意的复位和固定,疗效可靠。Objective To investigate the clinical effect of anterolateral mini-incision assisted reduction with InterTan intramedullary nail in the treatment of elderly refractory femoral intertrochanteric fractures to provide reference for clinical treatment.Methods Fifty-eight elderly patients with femoral intertrochanteric fractures admitted and treated in this hospital from August 2020 to April 2023 were selected as the study subjects and divided into the observation group and control group accroding to the operation program,29 cases in each group.The observation adopted the anterolateral mini-incision assisted reduction with InterTan intramedullary nail,in which there were 6 males and 23 females,the age averaged(86.14±4.98)years old.The control group adopted the closed reduction InterTan intramedullary nail therapy,in which there were 8 males and 21 females,the age averaged(86.33±5.09)years old.The intraoperative bleeding volume,hospitalization duration,incidence rate of fracture related complications,operation time,postoperative fracture reduction quality,postoperative medial cortical support type and postoperative hip joint Harris score were compared between the two groups.Results The two groups obtained the followed up,the follow up time was 6-12 months,with an average(11.45±1.59)months.There were no statistically significant differences in the intraoperative bleeding volume,hospitalization duration,incidence rate of fracture related complications between two groups(P>0.05).The operation time in the observation group was(88.79±29.58)min,which in the control group was(70.66±24.47)min,and there was statistical difference between the two groups(P<0.05).The excellent and good rate of fracture reduction quality in the observation group was 100.00%,which in the control group was 75.86%,and the difference between the two groups had statistical significance(P<0.05).The proportion of positive and neutral medial cortical support in the observation group was 96.55%,which in control group was 72.41%,and the difference betwe

关 键 词：高龄 股骨粗隆间骨折 InterTan髓内钉 辅助复位 

分 类 号：R687.3[医药卫生—骨科学]