小切口辅助复位在股骨转子间骨折中的应用效果分析  

Clinical Efficacy of Small⁃incision Assisted Reduction in Femoral Intertrochanteric Fracture

作　　者：吴丹 鄢江文 WU Dan;YAN Jiangwen(DepartmentⅡof General Surgery,Tonggu People’s Hospital,Yichun,Jiangxi 336200,China)

机构地区：[1]铜鼓县人民医院外二科,江西宜春336200

出　　处：《中国烧伤创疡杂志》2024年第6期464-467,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的分析小切口辅助复位在股骨转子间骨折中的应用效果。方法选取2019年10月至2023年2月铜鼓县人民医院收治的108例股骨转子间骨折患者作为研究对象,按照不同治疗方式将其分为小切口组(54例)与传统组(54例),小切口组患者行小切口辅助复位联合股骨近端防旋髓内钉(PFNA)内固定治疗,传统组患者行传统复位联合PFNA内固定治疗,对比观察两组患者手术相关指标、前内侧皮质复位情况、髋关节功能与并发症发生情况。结果小切口组患者术中失血量明显多于传统组(t=2.006,P=0.047)、手术时间明显长于传统组(t=3.663,P=0.001)。术后即刻,小切口组患者骨折端前内侧皮质复位情况为中性支撑9例、正性支撑45例,明显优于传统组患者的负性支撑5例、中性支撑18例、正性支撑31例(Z=-3.086,P=0.002)。出院时及术后6个月,小切口组患者Harris评分均明显高于传统组(t=2.396、3.826,P=0.018、P<0.001)。小切口组患者并发症发生率为5.56%,与传统组患者的并发症发生率11.11%无明显差异(χ^(2)=1.091,P=0.296)。结论小切口辅助复位联合PFNA内固定治疗股骨转子间骨折,虽术中失血量较大、手术时间较长,但能明显提高骨折端前内侧皮质复位质量及髋关节功能恢复效果。Objective To analyze the clinical efficacy of small⁃incision assisted reduction in femoral intertrochan⁃teric fracture.Methods 108 patients with femoral intertrochanteric fracture admitted to Tonggu People’s Hospital from October 2019 to February 2023 were enrolled as the research subjects,and divided into the small⁃incision group(n=54),receiving small⁃incision assisted reduction combined with proximal femoral nail antirotation(PFNA)internal fixation,and the traditional group(n=54),receiving the traditional reduction combined with PFNA internal fixation.The surgery⁃related indexes,anteromedial cortex reduction,hip joint function and the occurrence of complications were compared between the two groups.Results The intraoperative blood loss volume of patients in the small⁃incision group was significantly more than that in the traditional group(t=2.006,P=0.047),and the operation time was significantly longer in the small⁃incision group(t=3.663,P=0.001).Immediately after surgery,the reduction of the anteromedial cortex at the fracture end was anatomic reduction in 9 cases and positive buttress position in 45 cases in the small⁃incision group,which was significantly better than that of the patients in the traditional group(Z=-3.086,P=0.002)⁃negative buttress position in 5 cases,anatomic reduction in 18 cases,and positive buttress position in 31 cases.Respectively at discharge and on month 6 after operation,the Harris scores of patients was significantly higher in the small⁃incision group compared with the traditional group(t=2.396 and 3.826,P=0.018,P<0.001).The incidence of postoperative complications was 5.56%in the small⁃incision group,showing no significant difference compared with the 11.11%in the traditional group(χ^(2)=1.091,P=0.296).Conclusion Small⁃incision assisted reduction combined with PFNA internal fixation in treating femoral intertro⁃chanteric fracture can significantly improve the quality of anteromedial cortical reduction at the fracture end and the recovery effect of hip j

关 键 词：股骨近端 防旋髓内钉 小切口辅助复位 股骨转子间骨折 髋关节功能 

分 类 号：R687.3[医药卫生—骨科学]