C臂透视下股骨粗隆间骨折闭合复位空心拉力钉内固定术：88例基层医院经验报告

doi:10.3969/j.issn.1009-976X.2020.05.010

摘要/Abstract

摘要： 目的探讨C臂透视下股骨粗隆间骨折（IF）闭合复位空心拉力钉内固定术的临床效果。方法选取2014年1月~2018年1月我院IF患者176例,按治疗方案不同分观察组（n=88）、对照组（n=88）。对照组行传统钉板类内固定术,观察组行C臂透视下闭合复位空心拉力钉内固定术。比较两组手术情况（手术用时、术中失血量、骨性愈合用时）、术后6个月骨折愈合情况、并发症发生率、术前及术后6个月髋关节功能（Harris评分）、运动功能（FMA评分）。结果观察组手术用时、骨性愈合用时较对照组短,术中失血量较对照组少,差异有统计学意义（P<0.05）;术后6个月两组Harris、FMA评分均升高,且观察组高于对照组,差异有统计学意义（P<0.05）;观察组术后6个月骨折愈合优良率97.73%（86/88）较对照组79.55%（70/88）高,差异有统计学意义（P<0.05）;观察组并发症发生率2.27%（2/88）与对照组6.82%（6/88）对比,差异无统计学意义（P>0.05）。结论 C臂透视下闭合复位空心拉力钉内固定术治疗IF效果显著,能进一步促进骨折愈合,恢复髋关节功能及运动功能,且并发症少。

关键词: C臂, 髋关节功能, 运动功能, 空心拉力钉, 闭合复位, 内固定术, 股骨粗隆间骨折

Abstract: Objective To investigate the clinical effect of closed reduction and internal fixation with hollow tension nails for intertrochanteric fractures （IF） under C-arm perspective. Methods From January 2014 to January 2018, 176 patients with IF in our hospital were selected and divided into observation group （n=88） and control group （n=88） according to different treatment schemes. The control group underwent traditional nail plate internal fixation, and the observation group underwent closed reduction and internal fixation with hollow tension nails under C-arm fluoroscopy. The surgical conditions （time of operation, blood loss during operation, time of osseous healing）, fracture healing at 6 months after surgery, incidence of complications, hip function （Harris score）, and motor function （FMA score） before and after 6 months were compared between the two groups. Results The observation group had shorter operation time and bone healing time than the control group, and the blood loss during the operation was less than that of the control group, the difference was statistically significant （P<0.05）; the Harris and FMA scores of the two groups increased after 6 months, and the observation group was higher than the control group, and the difference was statistically significant （P<0.05）; the excellent healing rate of fracture healing in the observation group at 6 months after operation was 97.73% （86/88） higher than that in the control group at 79.55% （70/88）, and the difference was statistically significant （P<0.05）; the incidence of complications in the observation group was 2.27% （2/88） compared with 6.82% （6/88） in the control group, and the difference was not statistically significant （P>0.05）. Conclusion Closed reduction hollow cannula internal fixation under C-arm fluoroscopy has a significant effect on IF, can further promote fracture healing, restore hip joint function and motor function, and has fewer complications.

Key words: c-arm, internal fixation, motor function, hip joint function, intertrochanteric fracture, closed reduction, hollow tension nail

中图分类号:

R683.42

钱军, 林健, 苏树远. C臂透视下股骨粗隆间骨折闭合复位空心拉力钉内固定术：88例基层医院经验报告[J]. 岭南现代临床外科, 2020, 20(05): 593-596.

QIAN Jun, LIN Jian, SU Shu-yuan. Efficacy of closed reduction and internal fixation with hollow tension nail for intertrochanteric fracture of femur under C-arm： experience report of 88 cases of primary hospital[J]. Lingnan Modern Clinics in Surgery, 2020, 20(05): 593-596.

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