两种内固定方式治疗股骨转子下不稳定型骨折的疗效比较  

Comparison of two types of internal fixation for treatment of the unstable femoral subtrochanteric fracture

作　　者：尹亮 王式鲁 徐宏浩[1,2] 张凡 毕荣修[1,2] YIN Liang;WANG Shi-lu;XU Hong-hao;ZHANG Fan;BI Rong-xiu(The First Clinical Medical College,Shandong University of Chinese Medicine,Jinan,Shandong 250014,China;Dept of Traumatic Orthopaedics,the First Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250014,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250014 [2]山东中医药大学附属医院创伤骨科,山东济南250014

出　　处：《临床骨科杂志》2025年第2期273-277,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较髓内钉附加钢缆钢板与髓内钉附加钢缆固定治疗股骨转子下不稳定型骨折的疗效。方法根据手术方式不同将49例股骨转子下不稳定型骨折患者分为A组(12例,采用髓内钉附加钢缆钢板固定治疗)和B组(37例,采用髓内钉附加钢缆固定治疗)。记录两组手术情况、骨折复位及愈合情况、并发症发生情况,采用Harris评分评价髋关节功能恢复情况。结果患者均获得随访,时间12~18个月。手术时间、切口长度、术中出血量B组均短(少)于A组(P<0.01)。术中透视次数、完全负重时间B组多(长)于A组(P<0.05)。骨折复位不良率、骨折愈合时间A组低(短)于B组(P<0.05)。术后1、6个月Harris评分以及并发症发生率两组比较差异均无统计学意义(P>0.05)。结论髓内钉附加钢缆钢板与髓内钉附加钢缆固定治疗股骨转子下不稳定型骨折均能获得满意的效果。髓内钉附加钢缆固定切口较小,术中出血量少,手术时间短;附加钢缆钢板固定术中透视次数少,患者完全负重时间短。Objective To compare the curative effect of intramedullary nail attached steel cable-plate and intramedullary nail attached steel cable fixation on the unstable femoral subtrochanteric fracture.Methods According to the different surgical methods,49 patients with unstable femoral femoral subtrochanteric fractures were divided into group A(12 cases were treated with intramedullary nail attached steel cable-plate fixation)and group B(37 cases were treated with intramedullary nail attached steel cable fixation).The surgical conditions,fracture reduction and healing,complication incidence were recorded,and the recovery of hip joint function was evaluated with Harris score.Results All patients were followed up for 12~18 months.The operation time,incision length,and intraoperative bleeding volume in group B were all shorter(less)than those in group A(P<0.01).The intraoperative fluoroscopy frequency and the time to full weight-bearing in group B were both more(longer)than those in group A(P<0.05).The rate of poor fracture reduction and the time to fracture healing in group A were lower(shorter)than those in group B(P<0.05).There were no statistical differences in Harris scores at 1,6 months postoperation and the complications incidence between the two groups(P>0.05).Conclusions In the treatment of femoral subtrochanteric unstable fracture,the satisfactory effect can be obtained using intramedullary nail attached steel cable-plate and intramedullary nail attached steel cable fixation.Intramedullary nail attached steel cable fixation have smaller incision,less intraoperative blood loss,shorter operation time,and intramedullary nail attached steel cable-plate have fewer fluoroscopy frequency,and shorter full weight-bearing time of the patients.

关 键 词：股骨转子下骨折 髓内钉固定 锁定钢板 钢缆环扎 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]