基于体表标记引导优化髓内钉内固定技术治疗股骨粗隆间骨折  

Optimal intramedullary nailing technique in treatment of intertrochanteric fractures guided by body surface markers

作　　者：郭超韡 石腾博 刘又文[1] 李红军[1] 马文龙[1] 倘艳锋[1] 张军玲 周水红[1] GUO Chaowei;SHI Tengbo;LIU Youwen;LI Hongjun;MA Wenlong;TANG Yanfeng;ZHANG Junling;ZHOU Shuihong(Department of Hip Joint Surgery,Luoyang Orthopedic-Traumatological Hospital of Henan Province,Luoyang,Henan 471000,China;不详)

机构地区：[1]河南省洛阳正骨医院髋关节外科,河南洛阳471000 [2]河南中医药大学研究生院,河南郑州450046

出　　处：《中国骨与关节损伤杂志》2024年第8期794-798,共5页Chinese Journal of Bone and Joint Injury

基　　金：河南省中医药拔尖人才培养项目(豫卫中医函[2021]15号);河南省中医药科学研究专项重点项目(20-21ZY1061);河南省医学科技攻关计划联合共建项目(LHGJ20220251)。

摘　　要：目的探讨通过体表标记点线引导优化髓内钉内固定技术治疗股骨粗隆间骨折的临床疗效。方法回顾性分析自2020-06—2022-06于河南省洛阳正骨医院髋关节外科诊治的87例股骨粗隆间骨折,按照是否采用体表标记法进行分组,优化组43例采用体表标记法引导微创髓内钉内固定,常规组44例采用常规近端切口引导髓内钉内固定。比较两组术中透视次数、手术时间、切口长度、术中出血量以及术后6个月髋关节功能Harris评分。结果所有患者均获得随访,随访时间平均8.6(6~12)个月。两组均无骨折不愈合、内固定失效、螺旋刀片切出等情况发生。优化组透视次数15~36次,中位透视次数24次;常规组透视次数22~41次,中位透视次数30次。优化组透视次数较传统组少,差异有统计学意义(P<0.05)。两组手术时间、术后6个月髋关节功能Harris评分比较,差异均无统计学意义(P>0.05)。优化组切口长度小于常规组,差异有统计学意义(P<0.05)。优化组术中出血量小于常规组,差异有统计学意义(P<0.05)。结论通过体表标记划出点线使髓内钉近端置钉更加微创、精准,可以减少术中透视次数和术中出血量,利于快速康复,临床疗效良好。Objective To explore the clinical effect of minimally invasive intramedullary nailing technique for femoral intertrochanteric fractures guided by body surface markers.Methods A retrospective study of 87 cases of femoral intertrochanteric fractures treated in the hip surgery department of Luoyang Orthopedic-Traumatological Hospital of Henan Province from June 2020 to June 2022 was conducted.According to whether body surface markers were used,43 cases were treated with the body surface marking method(optimization group)while 44 cases were treated with the traditional technique for intramedullary nailing(conventional group).The operation time,intraoperative fluoroscopy times,skin incision length,intraoperative blood loss and postoperative hip function were compared between the two groups.Results All patients were followed up,with an average follow-up time of 8.6(6-12)months.There were no cases of nonunion,failure of internal fixation,or cut-out of screw.Optimization group had 15 to 36 fluoroscopic times,with a median view of 24 times.The conventional group had 22-41 fluoroscopy times,and the median fluoroscopy time was 30 times.Compared with the conventional group,the optimization group had fewer fluoroscopy times,with a statistically significant difference(P<0.05).There were no significant differences in operation time,or postoperative Harris hip function score between the two groups(P>0.05).The incision length of the optimization group was smaller than that of the conventional group,and the difference was statistically significant(P<0.05).The intraoperative blood loss in the optimization group was less than that in the conventional group,and the difference was statistically significant(P<0.05).Conclusion Body surface mark technique in the treatment of femoral intertrochanteric fractures is more minimally invasive and accurate,which can reduce the number of fluoroscopy and blood loss,facilitate rapid recovery,and improve the quality of life of patients.

关 键 词：股骨粗隆间骨折 体表标记 微创 内固定 股骨髓内钉 

分 类 号：R687.3[医药卫生—骨科学]