| 不同髓内固定方式治疗股骨转子间骨折的临床观察 |
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Received:October 11, 2023
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| 作者 | Author | 单位 | Unit | E-Mail |
| 金立昆 |
JIN Li-kun |
北京市丰盛中医骨伤专科医院, 北京 100033 |
Beijing Fengsheng Traditional Chinese Medicine Orthopaedic Hospital, Beijing 100033, China |
jinlikun99@163.com |
| 李晔 |
LI Ye |
北京市丰盛中医骨伤专科医院, 北京 100033 |
Beijing Fengsheng Traditional Chinese Medicine Orthopaedic Hospital, Beijing 100033, China |
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| 张杰 |
ZHANG Jie |
北京市丰盛中医骨伤专科医院, 北京 100033 |
Beijing Fengsheng Traditional Chinese Medicine Orthopaedic Hospital, Beijing 100033, China |
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| 董延旭 |
DONG Yan-xu |
北京市丰盛中医骨伤专科医院, 北京 100033 |
Beijing Fengsheng Traditional Chinese Medicine Orthopaedic Hospital, Beijing 100033, China |
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| 齐越峰 |
QI Yue-feng |
北京市丰盛中医骨伤专科医院, 北京 100033 |
Beijing Fengsheng Traditional Chinese Medicine Orthopaedic Hospital, Beijing 100033, China |
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| 期刊信息：《中国骨伤》2024年37卷，第3期，第293-299页 |
| DOI：10.12200/j.issn.1003-0034.20230275 |
| 基金项目:北京市优秀人才项目(编号:SD2019-12) |
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目的:探讨股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)、InterTan髓内钉和股骨近端仿生型髓内钉(proximal femoral bionic intramedullary nail,PFBN)治疗股骨转子间骨折的临床疗效。
方法:回顾性分析 2020年1月至2021年1月收治的120例接受闭合复位髓内钉内固定术股骨转子间骨折患者的临床资料,根据内固定方式分为3组。PFBN组25例,女16例,男9例,年龄69~79(73.67±5.16)岁;PFNA组55例,女38例,男17例,年龄68~80(74.23±5.57)岁;InterTan组40例,女26例,男14例,年龄68~79(73.45±5.34)岁。比较3组手术时间、术中出血量、切口长度、术后住院时间、负重时间及骨折愈合时间和并发症发生情况,分别于术前和术后1、6、12个月采用髋关节功能 Harris评分进行临床疗效评价。
结果:3组患者顺利完成手术,术后均随访12个月以上。3组住院时间、手术时间、术中出血量、切口长度比较,差异无统计学意义(P>0.05)。PFBN组、InterTan组负重时间[(7.98±1.34) d、(8.22±0.46) d],早于PFNA组(10.27±0.66) d(P<0.01);PFBN组、InterTan组骨折愈合时间[(10.14±2.33)周、(11.87±2.48)周],优于PFNA组(13.68±2.36)周(P<0.01)。术后1个月,PFBN组、InterTan组Harris评分[(70.52±5.34)分、(69.81±6.17)分],高于PFNA组(51.46±5.36)分(P<0.01),PFBN组和InterTan 组比较,差异无统计学意义(P>0.05)。3组术前及术后 6、12个月Harris评分比较,差异无统计学意义(P>0.05)。InterTan组、PFNA组并发症发生率低于PFNA组 (P<0.05)。
结论:PFBN和InterTan髓内钉治疗股骨转子间骨折较传统PFNA具有骨折愈合更快、负重时间更早且术后并发症更少的优势,但3种术式均可达到较高的有效率且远期效果无明显差异。 |
| [关键词]:股骨转子间骨折 股骨髓内钉 术后并发症 |
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| Clinical observation of different intramedullary fixation methods for the treatment of intertrochanteric fracture |
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Abstract:
Objective To explore clinical efficacy of proximal femoral nail anti-rotation(PFNA),InterTan and proximal femoral bionic intramedullary nail (PFBN) in treating femoral intertrochanteric fracture.
Methods Clinical data of 120 patients with intertrochanteric fracture who were underwent closed reduction intramedullary nail-internal fixation from January 2020 to January 2021 were retrospectively analyzed. According to methods of internal fixation,patients were divided into 3 groups. There were 25 patients in PFBN group,including 16 females and 9 males,aged from 69 to 79 years old with an average of (73.67±5.16) years old. There were 55 patients in PFNA group,including 38 females and 17 males,aged from 68 to 80 years old with an average of (74.23±5.57) years old. There were 40 patients in InterTan group,including 26 females and 14 males,aged from 68 to 79 years old with an average of (73.45±5.34) years old. Operative time,intraoperative blood loss,incision length,hospital stay,weight-bearing time,fracture healing time and complications among 3 groups were compared,and clinical effect was evaluated by Harris score of hip function before operation,1,6 and 12 months after opertaion,respectively.
Results Patients among 3 groups were successfully completed operation and were followed up for more than 12 months. There were no significant difference in hospital stay,operative time,intraoperative blood loss and incision length among 3 groups (P>0.05). Weight bearing time of PFBN group (7.98±1.34) d and InterTan group (8.22±0.46) d were earlier than that of PFNA group (10.27±0.66) d(P<0.01). Fracture healing time of PFBN group (10.14±2.33) weeks and InterTan group (11.87±2.48) weeks were earlier than that of PFNA group (13.68±2.36) weeks (P<0.01). One month after operation,Harris score in PFBN group (70.52±5.34) and InterTan group (69.81±6.17) was higher than that of PFNA group (51.46±5.36),and there was no significant difference between PFBN group and InterTan group (P>0.05). There were no significant difference in Harris scores among 3 groups before operation,6 and 12 months after opertaion(P>0.05). Cases of complication of InterTan group and PFNA group were lower than that of PFNA group (P<0.05).
Conclusion PFBN and InterTan for the treatment of intertrochanteric fracture have advantages of faster fracture healing,earlier weight-bearing time and fewer postoperative complications than traditional PFNA,but three operations could achieve higher effective rates without significant difference in long-term results. |
| KEYWORDS:Intertrochanteric fracture Femoral intramedullary nail Postoperative complication |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 金立昆,李晔,张杰,董延旭,齐越峰.不同髓内固定方式治疗股骨转子间骨折的临床观察[J].中国骨伤,2024,37(3):293~299 |
| 英文格式: | JIN Li-kun,LI Ye,ZHANG Jie,DONG Yan-xu,QI Yue-feng.Clinical observation of different intramedullary fixation methods for the treatment of intertrochanteric fracture[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(3):293~299 |
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