| 偏心固定与髓内固定治疗股骨转子间骨折的病例对照研究 |
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投稿时间：2014-09-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 张颖 |
ZHANG Ying |
河南省洛阳正骨医院, 河南 洛阳 471002
广州中医药大学, 广东 广州 510405 |
Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China |
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| 何伟 |
HE Wei |
广州中医药大学, 广东 广州 510405 |
Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China |
hw13802516062@126.com |
| 刘又文 |
LIU You-wen |
河南省洛阳正骨医院, 河南 洛阳 471002 |
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| 冯立志 |
FENG Li-zhi |
广州中医药大学, 广东 广州 510405 |
Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China |
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| 期刊信息：《中国骨伤》2015年，第28卷，第2期，第117-121页 |
| DOI：10.3969/j.issn.1003-0034.2015.02.005 |
| 基金项目: |
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中文摘要:
目的:比较股骨转子间骨折采用偏心固定及髓内固定两种方法的疗效,为股骨转子间骨折治疗方法的选择提供理论依据.
方法:2007年2月至2010年1月收治股骨转子间骨折患者82例,其中偏心固定组39例,男16例,女23例,年龄41～81岁,平均(62.68±10.69)岁,采用动力髋或股骨近端锁定钢板固定;髓内固定组43例,男15例,女28例,年龄43～78岁,平均(62.60±8.37)岁,采用PFN或PFNA固定.比较两组患者的切口长度、手术时间、术中出血量以及术后Harris评分情况.
结果:两组伤口均Ⅰ期愈合,无手术并发症.82例患者均获得随访,时间12～28个月,平均18.3个月.两组切口长度、手术时间、术中出血量差异具有统计学意义.两组术后1个月Harris髋关节功能评分比较差异有统计学意义(P<0.05),而术后12个月Harris髋关节功能评分差异无统计学意义(P>0.05).偏心固定组优良率为89.7%,髓内固定组优良率为90.7%,差异无统计学意义(P>0.05).偏心固定组骨折不愈合1例,动力髋主钉螺丝松动并继而发生髋内翻畸形.髓内固定组无防旋钉退出,髓内钉远端股骨再骨折1例.
结论:两种方法治疗股骨转子间骨折均有良好疗效,但是髓内固定较偏心固定手术时间更短,出血量更少,适用于骨质疏松和不稳定型股骨转子间骨折的治疗. |
| 【关键词】转子间骨折 股骨骨折 骨折固定术,内 骨折固定术,髓内 病例对照研究 |
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| Comparison of the efftec between eccentric fixation and intramedullary fixation for treatment of intertrochanteric fractures |
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ABSTRACT
Objective:To compare the efficacy between eccentric fixation and internal fixation for treatment of intertrochanteric fractures of femur,to provide a theoretical basis for the selection of the treatment method of the intertrochanteric fractures of femur.
Methods:From February 2007 to January 2010,82 patients with femoral intertrochanteric fracture were treated by internal fixation including 39 cases of eccentric fixation involving 23 males and 6 females,aged from 41 to 81 years old with an average of (62.68±10.69),using the DHS or proximal femoral locking plate; 43 cases of intramedullary fixation involving 15 males,28 females,aged from 43 to 78 years old with an average of(62.60±8.37),using PFN or PFNA fixed. The surgical incision length,operative time,blood loss and postoperative Harris score between two groups were compared.
Results:The wound of two groups were primary healing without operative complications. All cases received follow-up for an average time of 18.3 months (12 to 28 months). The incision length,operative time and blood loss had a statistically significant difference between two groups (P<0.05). Harris scores of hip joint function at 1 month after operation had statistically significant difference between two groups (P<0.05),and Harris scores at 12 months after operation had no statistical significance difference between two groups. The rate of excellent and good was 89.7% in eccentric fixation group and 90.7% in intramedullary fixation group,the difference was not statistically significant(t=0.0613,P>0.05). In eccentric fixation group,there was 1 case of fracture nonunion with DHS loose and ensuing hip varus deformity. In intramedullary nail fixation group,there was no anti-rotation out,distal intramedullary nail of femoral refracture occurred in 1 case.
Conclusion:Two treatment methods for the treatment of femoral fractures had a good therapeutic effect,but the intramedullary fixation had shorter operative time and less blood loss than the eccentric fixation,it prior to apply to osteoporosis and unstable femoral intertrochanteric fractures. |
| KEY WORDS Intertrochanteric fractures Femoral fractures Fracture fixation,internal Fracture fixation,intramedullary Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张颖,何伟,刘又文,冯立志.偏心固定与髓内固定治疗股骨转子间骨折的病例对照研究[J].中国骨伤,2015,28(2):117~121 |
| 英文格式: | ZHANG Ying,HE Wei,LIU You-wen,FENG Li-zhi.Comparison of the efftec between eccentric fixation and intramedullary fixation for treatment of intertrochanteric fractures[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(2):117~121 |
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