| 股骨近端防旋髓内钉联合锁定钢板治疗合并外侧壁骨折的股骨转子间骨折 |
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投稿时间：2023-08-10
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| 作者 | Author | 单位 | Address | E-Mail |
| 彭硕 |
PENG Shuo |
广西壮族自治区江滨医院骨科, 广西 南宁 530021 |
Department of Orthopaedics, Guangxi Zhuang Autonomous Region Jiangbin Hospital, Nannning 530021, Guangxi, China |
86755376@qq.com |
| 黄菲菲 |
HUANG Fei-fei |
广西壮族自治区江滨医院骨科, 广西 南宁 530021 |
Department of Orthopaedics, Guangxi Zhuang Autonomous Region Jiangbin Hospital, Nannning 530021, Guangxi, China |
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| 夏丽伟 |
XIA Li-wei |
广西壮族自治区江滨医院骨科, 广西 南宁 530021 |
Department of Orthopaedics, Guangxi Zhuang Autonomous Region Jiangbin Hospital, Nannning 530021, Guangxi, China |
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| 黄坚汉 |
HUANG Jian-han |
广西壮族自治区江滨医院骨科, 广西 南宁 530021 |
Department of Orthopaedics, Guangxi Zhuang Autonomous Region Jiangbin Hospital, Nannning 530021, Guangxi, China |
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| 蒙诗景 |
MENG Shi-jing |
广西壮族自治区江滨医院骨科, 广西 南宁 530021 |
Department of Orthopaedics, Guangxi Zhuang Autonomous Region Jiangbin Hospital, Nannning 530021, Guangxi, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第8期，第796-800页 |
| DOI：10.12200/j.issn.1003-0034.20230029 |
| 基金项目:广西医疗卫生适宜技术开发与推广应用项目(编号:S2020063) |
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中文摘要:
目的：探讨锁定钢板内固定治疗股骨近端外侧壁骨折块后的效果。
方法：2021年1月至2022年6月收治31例合并外侧壁骨折的股骨转子间骨折患者,其中15例单纯采用股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)固定,男3例,女12例;年龄(75.87±7.46)岁;另16例采用 PFNA内固定后再应用预弯好的3.5 mm螺孔锁定钢板内固定外侧壁骨折,男4例,女12例;年龄(76.15±9.47)岁。术后随访观察记录比较两组手术指标、尖顶距(tip-apical distance,TAD)、术后负重站立时间、骨折复位情况。术后6个月根据Harris髋关节评分评价术后髋关节功能。
结果：两组患者均获得随访,时间7~17(12±5)个月。两组术后即刻颈干角为111°~132°(119.3±8.3)°。骨折复位效果:PFNA组,优11例,可2例,差1例;PFNA+锁定钢板组,优12例,可3例,差1例。PFNA组1例发生螺旋刀片经股骨头切出。两组手术时间、术中出血量及手术切口长度比较,差异有统计学意义(P<0.05);两组TAD及术后负重站立时间比较,差异无统计学意义(P>0.05)。两组术后6个月Harris各项评分和总分比较,差异有统计学意义(P<0.05)。
结论：应用PFNA辅助锁定钢板内固定合并外侧壁骨折的股骨转子间骨折疗效确切,可较好恢复外侧壁完整性,提高PFNA内固定的稳定性,术后并发症少。 |
| 【关键词】股骨转子间骨折 外侧壁 不稳定型骨折 锁定钢板 股骨近端防旋髓内钉 |
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| Proximal femoral nail antirotation combined with locking plate in the treatment of femoral intertrochanteric fractures with lateral wall fractures |
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ABSTRACT
Objective To investigate the effect of locking plate internal fixation for the treatment of proximal lateral femoral wall fracture.
Methods From January 2021 to June 2022,31 patients with intertrochanteric fractures and lateral wall fractures were treated. Among them,15 patients were treated with proximal femoral nail antirotation (PFNA) fixation including 3 males and 12 females with an average age of (75.87±7.46) years old;the other 16 patients were treated with 3.5 mm pre-curved screw locking plate fixtion for lateral wall fracture including 4 males and 12 females with an average age of (76.15±9.47) years old. After surgery,the surgical index,tip-apical distance(TAD),postoperative standing weight-bearing time,and fracture reduction were compared between two groups. Postoperative hip function was evaluated according to Harris hip score.
Results All patients were followed up for an average of (12±5) months ranging from 7 to 17 months. The immediate postoperative neck angle ranged from 111° to 132°(119.3±8.3)°. Fracture reduction results were excellent in 11 cases,fair in 2,worse in 1 in PFNA group;excellent in 12,fair in 3,worse in 1 in PFNA+locking plate group. One case of the PFNA group had a spiral blade cut out through the femoral head. There were significant differences in the time of operation,the amount of blood loss during the operation,the length of incision between two groups(P<0.05). There was no significant difference in TAD and postoperative standing weight-bearing time between two groups(P>0.05). There were significant differences in Harris scores at 6 months after surgery between two groups(P<0.05).
Conclusion The application of PFNA-assisted locking plate in the treatment of femoral intertrochanteric fractures with lateral wall fractures is effective,and can restore the integrity of lateral wall,improve the stability of PFNA internal fixation,and reduce postoperative complications. Lateral wall; Unstable fracture; Locking plate; Proximal femoral nail antirotation(PFNA) |
| KEY WORDS Femoral intertrochanteric fracture Lateral wall Unstable fracture Locking plate Proximal femoral nail antirotation(PFNA) |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 彭硕,黄菲菲,夏丽伟,黄坚汉,蒙诗景.股骨近端防旋髓内钉联合锁定钢板治疗合并外侧壁骨折的股骨转子间骨折[J].中国骨伤,2024,37(8):796~800 |
| 英文格式: | PENG Shuo,HUANG Fei-fei,XIA Li-wei,HUANG Jian-han,MENG Shi-jing.Proximal femoral nail antirotation combined with locking plate in the treatment of femoral intertrochanteric fractures with lateral wall fractures[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(8):796~800 |
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