| PFNA联合重建锁定钛板治疗累及外侧壁的粉碎性股骨粗隆间骨折 |
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投稿时间：2018-05-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈志祥 |
CHEN Zhi-xiang |
南通大学附属医院, 江苏 南通 226000
淮安市淮阴医院, 江苏 淮安 223300 |
Afficliated Hospital of Nantong University, Nantong 226000, Jiangsu, China |
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| 周振宇 |
ZHOU Zhen-yu |
南通大学附属医院, 江苏 南通 226000 |
Afficliated Hospital of Nantong University, Nantong 226000, Jiangsu, China |
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| 刘璠 |
LIU Fan |
南通大学附属医院, 江苏 南通 226000 |
Afficliated Hospital of Nantong University, Nantong 226000, Jiangsu, China |
liufan19575@aliyun.com |
| 杨峰 |
YANG Feng |
淮安市淮阴医院, 江苏 淮安 223300 |
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| 王传功 |
WANG Chuan-gong |
淮安市淮阴医院, 江苏 淮安 223300 |
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| 期刊信息：《中国骨伤》2018年，第31卷，第9期，第840-845页 |
| DOI：10.3969/j.issn.1003-0034.2018.09.012 |
| 基金项目: |
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中文摘要:
目的：探讨股骨近端抗旋髓内钉（PFNA）联合重建锁定钛板治疗累及外侧壁的粉碎性股骨粗隆间骨折的手术疗效。
方法：2014年11月至2016年1月，35例累及外侧壁的粉碎性股骨粗隆间骨折（AO分型31-A3.3）患者采用手术治疗，按是否重建外侧壁及内固定方式分为PFNA组（未重建外侧壁）、PFNA联合重建组（使用重建锁定钛板复位重建外侧壁联合PFNA内固定），通过分析手术时间、术中失血量、术后下床时间、骨折愈合时间、有无并发症及术后12个月时髋关节Harris评分进行临床疗效评价。
结果：35例患者均顺利完成手术，术后切口均Ⅰ期愈合，无切口感染、脂肪液化发生。35例患者均获得随访，时间12~16个月，平均14.4个月。所有骨折骨性愈合，两组手术时间、术中出血量差异无统计学意义（P>0.05）。PFNA组术后5例出现并发症，PFNA联合重建组1例出现并发症，两组比较差异有统计学意义（P<0.05）；术后下床时间、骨性愈合时间、并发症、Harris评分PFNA联合重建组均优于PFNA组，组间比较差异均有统计学意义（P<0.05）。
结论：PFNA联合重建锁定钛板治疗累及外侧壁的粉碎性股骨粗隆间骨折虽然手术时间及出血量较PFNA组多，手术创伤较PFNA大，但术后骨折愈合时间及下床活动时间、髋关节功能等均优于PFNA组，能够有效地缩短患者术后卧床时间，减少卧床并发症及改善患者髋关节功能。 |
| 【关键词】股骨骨折 骨折,粉碎性 骨折固定术,髓内 |
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| PFNA combined reconstruction and locking titanium plate for the treatment of comminuted femoral intertrochanteric fractures involving lateral wall |
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ABSTRACT
Objective: To investigate the operative effect of PFNA combined with reconstructive locking plate on the treatment of comminuted femoral intertrochanteric fracture which involving the lateral wall.
Methods: A total of 35 patients with comminuted femoral intertrochanteric fractures involving the lateral wall were surgically treated from November 2014 to January 2016. According to whether there was reconstruction of the lateral wall or not and the internal fixation method,the patients were divided into PFNA group (no reconstruction of the lateral wall),PFNA recontruction group (reconstructive locking plate was used to reconstruct the lateral wall,PFNA internal fixation). The clinical curative effect was evaluated by the analysis of operation time,intraoperative blood loss,postoperative activity time,the time of fracture healing,complications,and hip joint Harris score at 12 months after operation.
Results: All 35 patients completed the operation successfully. All the incisions were healed by first intention and no incision infection or fat liquefaction occurred. All 35 patients were followed up from 12 to 16 months with an average of 14.4 months. All patients had bone healing. There was no statistical significant in surgery time and intraoperative blood loss between two groups(P>0.05). There were 5 postoperative complications in the PFNA group and 1 in the PFNA combined with reconstructive locking plate group. There was a statistical difference between two groups(P<0.05). The postoperative activity time,bone healing time,complications,and Harris score of PFNA reconstruction group were all superior to PFNA group,there were statistically significant differences between two groups.
Conclusion: Although the operation time and blood loss of PFNA combined with reconstructive locking plate in treatment of comminuted femoral intertrochanteric fracture which involving the lateral wall are more than those in the PFNA group,and the surgical trauma is larger than PFNA,the fracture healing time,postoperative activity time,and hip joint function were all superior to those of the PFNA group,which can effectively shorten the postoperative bed rest time,and reduce bed complications as well as improve hip joint function. |
| KEY WORDS Femoral fractures Fractures,comminuted Fracture fixation,intramedullary |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈志祥,周振宇,刘璠,杨峰,王传功.PFNA联合重建锁定钛板治疗累及外侧壁的粉碎性股骨粗隆间骨折[J].中国骨伤,2018,31(9):840~845 |
| 英文格式: | CHEN Zhi-xiang,ZHOU Zhen-yu,LIU Fan,YANG Feng,WANG Chuan-gong.PFNA combined reconstruction and locking titanium plate for the treatment of comminuted femoral intertrochanteric fractures involving lateral wall[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(9):840~845 |
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