InterTAN髓内钉固定术中内侧皮质不同复位情况对近远期髋关节功能、骨丢失量的影响  

Effects of Different Reduction of the Medial Cortex during InterTAN Intramedullary Nailing on Short-term and Long-term Hip Function and Bone Loss

作　　者：杨勇胜 冷清修 严晨 谢敏波 万永民 方钊 YANG Yongsheng;LENG Qingxiu;YAN Chen;XIE Minbo;WAN Yongmin;FANG Zhao(Department of Orthopedics,the Second People's Hospital of Jingdezhen,Jingdezhen 333000,China;不详)

机构地区：[1]景德镇市第二人民医院骨科,江西景德镇333000

出　　处：《中国医学创新》2025年第8期91-95,共5页Medical Innovation of China

基　　金：景德镇市科技计划项目(20231SFZC053)。

摘　　要：目的:探究股骨近端InterTAN髓内钉固定术中内侧皮质不同复位情况对近远期髋关节功能、骨丢失量的影响。方法:选取景德镇市第二人民医院2021年2月—2023年2月收治的股骨骨折患者80例为研究对象,进行回顾性分析,依据内侧皮质复位程度将患者分为正性支撑组(A组)27例、中性支撑组(B组)26例和负性支撑组(C组)27例;比较三组恢复情况、骨丢失量、Harris髋关节评分、视觉模拟评分法(VAS)评分、欧洲五维健康量表(EQ-5D)评分。结果:A组、B组首次下地部分负重时间、骨折愈合时间均较C组早,A组首次下地部分负重时间、骨折愈合时间均较B组早(P<0.05);A组术后12个月股骨颈干角丢失、股骨颈长度丢失均较B组、C组少,B组股骨颈干角丢失、股骨颈长度丢失均较C组少(P<0.05);术后3个月,A组Harris髋关节评分高于C组(P<0.05);术后6、12个月,A组Harris评分均高于B组、C组,且B组均高于C组(P<0.05);术后3个月,A组VAS评分低于C组(P<0.05);术后6、12个月,A组VAS评分均低于B组、C组,且B组均低于C组(P<0.05);术后3个月,A组、B组EQ-5D评分均高于C组(P<0.05);术后6、12个月,A组EQ-5D评分均高于B组、C组,且B组均高于C组(P<0.05)。结论:InterTAN髓内钉固定术中选用正性支撑临床疗效最好,能加快骨折患者的康复,减少骨丢失,有效恢复髋关节,内侧皮质复位情况选择时应尽量选择正性支撑、中性支撑,避免负性支撑。Objective:To investigate the effects of different reduction of the medial cortex during proximal femoral InterTAN intramedullary nailing on short-term and long-term hip function and bone loss.Method:Eighty patients with femoral fractures who were admitted to the Second People's Hospital of Jingdezhen from February 2021 to February 2023 were selected as the study subjects.A retrospective analysis was performed.According to the reduction of medial cortex,the patients were divided into positive support group(group A,27 cases),neutral support group(group B,26 cases)and negative support group(group C,27 cases).The recovery,bone loss,Harris hip score,visual analogue scale(VAS)score and European quality of life-5 dimensions(EQ-5D)scores were compared among the three groups.Result:The initial partial weight-bearing time and fracture healing time in group A and group B were earlier than those in group C,the initial partial weight-bearing time and fracture healing time in group A were earlier than those in group B(P<0.05).The loss of femoral neck shaft angle and loss of femoral neck length at 12 months after surgery in group A were less than those in group B and group C,the loss of femoral neck shaft angle and loss of femoral neck length in group B were less than those in group C(P<0.05).At 3 months after surgery,Harris hip score of group A was higher than that of group C(P<0.05).At 6 and 12 months after surgery,Harris hip scores of group A were higher than those of group B and group C,and Harris hip scores of group B were higher than those of group C(P<0.05).At 3 months after surgery,VAS score of group A was lower than that of group C(P<0.05).At 6 and 12 months after surgery,VAS scores of group A were lower than those of group B and group C,and VAS scores of group B were lower than those of group C(P<0.05).At 3 months after surgery,the EQ-5D score in group A and group B was higher than that in group C(P<0.05).At 6 and 12 months after surgery,the EQ-5D scores of group A were higher than those of group B and group C,and tho

关 键 词：股骨骨折 股骨近端InterTAN 髋关节功能 内侧皮质 骨丢失量 

分 类 号：R68[医药卫生—骨科学]