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[1]朱曉波,鄭杰,錢晶晶.順勢雙反牽引復(fù)位器復(fù)位髓內(nèi)釘內(nèi)固定治療股骨干骨折的臨床研究[J].中醫(yī)正骨,2023,35(01):20-24.
　ZHU Xiaobo,ZHENG Jie,QIAN Jingjing.A clinical study of homeopathic double reverse traction repositor-assisted reduction and intramedullary nailing internal fixation for treatment of femoral shaft fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(01):20-24.
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順勢雙反牽引復(fù)位器復(fù)位髓內(nèi)釘內(nèi)固定治療股骨干骨折的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年01期
頁碼:
20-24
欄目:
臨床研究
出版日期:
2023-01-20

文章信息/Info

Title:
A clinical study of homeopathic double reverse traction repositor-assisted reduction and intramedullary nailing internal fixation for treatment of femoral shaft fractures
作者:
朱曉波; 鄭杰; 錢晶晶
(舟山醫(yī)院,浙江 舟山 316021)
Author(s):
ZHU Xiaobo; ZHENG Jie; QIAN Jingjing
Zhoushan Hospital,Zhoushan 316021,Zhejiang,China
關(guān)鍵詞:
股骨骨折;  牽引術(shù);  骨折固定術(shù); 髓內(nèi);  骨釘;  臨床試驗
Keywords:
femoral fractures;  traction;  fracture fixation; intramedullary;  bone nails;  clinical trial
摘要:
目的:觀察順勢雙反牽引復(fù)位器復(fù)位髓內(nèi)釘內(nèi)固定治療股骨干骨折的臨床療效及安全性。方法:回顧性分析2019年5月至2021年5月收治的30例股骨干骨折患者的病例資料,均采用髓內(nèi)釘內(nèi)固定治療,其中15例采用順勢雙反牽引復(fù)位器復(fù)位(復(fù)位器組)、15例采用牽引床復(fù)位(牽引床組)。比較2組患者的復(fù)位時間、術(shù)中X線透視次數(shù)、手術(shù)時間、術(shù)中出血量,以及術(shù)后2周膝部疼痛視覺模擬量表(visual analogue scale,VAS)評分、術(shù)后6個月美國特種外科醫(yī)院(Hospital for Special Surgery,HSS)膝關(guān)節(jié)評分、術(shù)后并發(fā)癥發(fā)生情況。結(jié)果:2組患者骨折均愈合。復(fù)位器組在復(fù)位時間、術(shù)中X線透視次數(shù)、手術(shù)時間、術(shù)中出血量、術(shù)后2周膝部疼痛VAS評分方面均優(yōu)于牽引床組[(8.36±2.53)min,(20.27±5.38)min,t=12.390,P=0.000;(10.51±3.22)次,(18.64±2.73)次,t=7.459,P=0.000;(85.22±20.34)min,(110.56±21.25)min,t=3.336,P=0.002;(120.23±21.68)mL,(180.67±21.23)mL,t=7.714,P=0.000;(3.27±2.02)分,(5.20±1.97)分,t=-2.665,P=0.013]; 2組患者術(shù)后6個月HSS膝關(guān)節(jié)評分比較,組間差異無統(tǒng)計學(xué)意義[(88.22±6.34)分,(80.32±2.71)分,t=1.146,P=0.261]。術(shù)后復(fù)位器組出現(xiàn)下肢深靜脈血栓1例、下肢力線不良1例,牽引床組出現(xiàn)下肢深靜脈血栓1例、會陰部擠壓傷3例、足踝部擠壓傷1例、切口脂肪液化1例、腓總神經(jīng)損傷2例、下肢力線不良2例、貧血1例,復(fù)位器組的并發(fā)癥發(fā)生率低于牽引床組(P=0.003)。結(jié)論:順勢雙反牽引復(fù)位器復(fù)位髓內(nèi)釘內(nèi)固定治療股骨干骨折,與牽引床復(fù)位髓內(nèi)釘內(nèi)固定相比,兩者在膝關(guān)節(jié)功能恢復(fù)方面無明顯差異,但前者比后者的復(fù)位時間短、術(shù)中X線透視次數(shù)少、手術(shù)時間短、術(shù)中出血量少、術(shù)后膝部疼痛改善情況好,且并發(fā)癥少。
Abstract:
Objective:To observe the clinical efficacy and safety of homeopathic double reverse traction repositor(DRTR)-assisted reduction and intramedullary nailing(IMN)internal fixation for treatment of femoral shaft fractures.Methods:The medical data of 30 patients with femoral shaft fractures admitted from May 2019 to May 2021 were retrospectively analyzed.All patients were treated with IMN.Specifically,15 cases underwent homeopathic DRTR-assisted reduction(DRTR group),while the remaining 15 cases underwent traction table-assisted reduction(traction table group).The reduction time,intraoperative X-ray exposure,operation time,and intraoperative blood loss,as well as the Visual Analogue Scale(VAS)score evaluated for knee pain at two weeks after operation,Hospital for Special Surgery(HSS)knee score evaluated at six months after operation,and incidence of postoperative complications were compared between the two groups.Results:Fracture healing was observed in both groups.The DRTR group was superior to the traction table group in reduction time,intraoperative X-ray exposure,operation time,intraoperative blood loss,and VAS score evaluated for knee pain at two weeks after surgery(8.36±2.53 vs 20.27±5.38 min,t=12.390,P=0.000; 10.51±3.22 vs 18.64±2.73,t=7.459,P=0.000; 85.22±20.34 vs 110.56±21.25 min,t=3.336,P=0.002; 120.23±21.68 vs 180.67±21.23 mL,t=7.714,P=0.000; 3.27±2.02 vs 5.20±1.97,t=-2.665,P=0.013).There was no significant difference in HSS knee score between the two groups at six months after operation(88.22±6.34 vs 80.32±2.71,t=1.146,P=0.261).In the DRTR group,deep vein thrombosis(DVT)occurred in one case and poor lower limb alignment in one case.In the traction table group,DVT occurred in one case,perineal crush injury in three cases,ankle crush injury in one case,fat liquefaction in the incision in one case,peroneal nerve injury in two cases,poor lower limb alignment in two cases,and anemia in one case.The incidence of complications in the DRTR group was lower than that in the traction table group(P=0.003).Conclusion:In terms of functional recovery of knee joint,homeopathic DRTR-assisted reduction and IMN internal fixation in the treatment of femoral fractures was comparative to traction table-assisted reduction and IMN internal fixation,but the former showed shorter reduction time,less intraoperative X-ray exposure,shorter operation time,less intraoperative blood loss,better improvement of postoperative knee pain,and fewer complications.

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(收稿日期:2022-07-25 本文編輯:郭毅曼)

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更新日期/Last Update: 1900-01-01