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[1]萬(wàn)超,鄒季,朱小虎.動(dòng)力髖螺釘加子釘與股骨近端防旋髓內(nèi)釘治療老年股骨轉(zhuǎn)子間A2型骨折的對(duì)比研究[J].中醫(yī)正骨,2013,25(07):24-27.
　WAN Chao*,ZOU Ji,ZHU Xiao-hu.*.A retrospective trial of dynamic hip screw fixation combined with auxiliary screw fixation versus proximal femoral nail antirotation fixation for type A2 intertrochanteric fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(07):24-27.
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動(dòng)力髖螺釘加子釘與股骨近端防旋髓內(nèi)釘治療老年股骨轉(zhuǎn)子 間A2型骨折的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期數(shù):
2013年07期
頁(yè)碼:
24-27
欄目:
髖部損傷
出版日期:
2013-07-31

文章信息/Info

Title:
A retrospective trial of dynamic hip screw fixation combined with auxiliary screw fixation versus proximal femoral nail antirotation fixation for type A2 intertrochanteric fractures in old patients
作者:
萬(wàn)超1; 鄒季1; 朱小虎2
1.湖北中醫(yī)藥大學(xué),湖北 武漢 430061; 2.湖北醫(yī)藥學(xué)院附屬太和醫(yī)院,湖北 十堰 442000
Author(s):
WAN Chao*; ZOU Ji; ZHU Xiao-hu.*
Hubei University of Chinese Medicine,Wuhan 430061,Hubei,China
關(guān)鍵詞:
髖骨折 老年人 骨折固定術(shù); 內(nèi) 治療; 臨床研究性 動(dòng)力髖螺釘股骨近端防旋髓內(nèi)釘
Keywords:
Hip fractures;  Aged;  Fracture fixation; internal;  Therapies; investigational;  Dynamic hip screw;  Proximal femoral nail antirotation
摘要:
目的:比較動(dòng)力髖螺釘加子釘固定與股骨近端防旋髓內(nèi)釘固定治療老年股骨轉(zhuǎn)子間A2型骨折的臨床療效和安全性。方法:回顧性分析接受手術(shù)治療的70例老年股骨轉(zhuǎn)子間A2型骨折患者的臨床資料,采用動(dòng)力髖螺釘加子釘固定者37例(DHS組),采用股骨近端防旋髓內(nèi)釘固定者33例(PFNA組)。比較2組患者的切口長(zhǎng)度、手術(shù)時(shí)間、術(shù)中出血量、術(shù)后引流量、住院時(shí)間、骨折愈合時(shí)間、術(shù)后12個(gè)月隨訪時(shí)的d'Aubigné-Postel髖關(guān)節(jié)評(píng)分及并發(fā)癥發(fā)生率。結(jié)果:①一般情況。2組患者均獲隨訪,時(shí)間12～24個(gè)月,中位數(shù)16.5個(gè)月。PFNA組患者的切口長(zhǎng)度、手術(shù)時(shí)間、術(shù)中出血量及術(shù)后引流量均少于DHS組[(13.80±1.90)cm,(22.50±1.60)cm,t=20.792,P=0.000;(60.40±16.50)min,(77.20±15.50)min,t=4.391,P=0.000;(223.50±110.70)mL,(347.80±120.60)mL,t=4.474,P=0.000;(87.20±46.40)mL,(227.50±50.80)mL,t=12.013,P=0.000]; PFNA組患者的住院時(shí)間及骨折愈合時(shí)間與DHS組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(19.50±3.20)d,(20.00±3.10)d,t=0.663,P=0.510;(3.20±2.10)個(gè)月,(3.30±2.30)個(gè)月,t=0.189,P=0.851]。②髖關(guān)節(jié)功能。DHS組優(yōu)17例,良12例,中6例,差2例; PFNA組優(yōu)15例,良13例,中4例,差1例。2組患者髖關(guān)節(jié)功能比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(U=0.346,P=0.910)。③并發(fā)癥。DHS組6例發(fā)生股骨頸短縮,8例發(fā)生髖內(nèi)翻,PFNA組1例發(fā)生髖內(nèi)翻。2組患者均未發(fā)生感染及靜脈血栓栓塞。DHS組患者的并發(fā)癥發(fā)生率高于PFNA組(χ2=12.552,P=0.000)。結(jié)論:動(dòng)力髖螺釘加子釘固定與股骨近端防旋髓內(nèi)釘固定治療老年股骨轉(zhuǎn)子間A2型骨折療效相當(dāng),但后者具有創(chuàng)傷小、手術(shù)時(shí)間短及并發(fā)癥少的優(yōu)勢(shì)。
Abstract:
Objective:To compare the clinical curative effects and safety of dynamic hip screw(DHS)fixation combined with auxiliary screw fixation with those of proximal femoral nail antirotation(PFNA)fixation for type A2 intertrochanteric fractures in old patients.Methods:The clinical records of 70 old patients who underwent operative treatment for type A2 intertrochanteric fractures were analyzed retrospectively.Thirty-seven patients(DHS group)were administrated with DHS fixation combined with auxiliary screw fixation,while the others(PFNA group)were administrated with PFNA fixation.The two groups were compared with each other in such parameters as incision length,operative time,blood loss,postoperative drainage,hospital stay,fracture healing time,d'Aubigné-Postel hip scores at 12 months after operation and incidence rate of complications.Results:The patients in the 2 groups were all followed up for 12-24 months with a median of 16.5 months.The incision length,operative time,blood loss and postoperative drainage of PFNA group were all lower than those of DHS group[(13.80±1.90)cm vs(22.50±1.60)cm,t=20.792,P=0.000;(60.40±16.50)min vs(77.20±15.50)min,t=4.391,P=0.000;(223.50±110.70)mL vs(347.80±120.60)mL,t=4.474,P=0.000;(87.20±46.40)mL vs(227.50±50.80)mL,t=12.013,P=0.000].There were no statistical differences in hospital stay and fracture healing time between PFNA group and DHS group[(19.50±3.20)d vs(20.00±3.10)d,t=0.663,P=0.510;(3.20±2.10)months vs(3.30±2.30)months,t=0.189,P=0.851].Seventeen patients obtained an excellent result,12 good,6 fair and 2 poor in DHS group; while 15 patients obtained an excellent result,13 good,4 fair and 1 poor in PFNA group.There was no statistical difference in hip function between the 2 groups(U=0.346,P=0.910).Six patients with femoral neck shortening,8 cases with coxa vara were found in DHS group,while 1 case with coxa vara was found in PFNA group.No patients with infection and venous thromboembolism were found in the 2 groups.The incidence rate of complications of DHS group was higher than that of PFNA group(χ2=12.552,P=0.000).Conclusion:The therapy of DHS fixation combined with auxiliary screw fixation is similar to PFNA fixation in curative effect in the treatment of type A2 intertrochanteric fractures in old patients,while the latter has the advantages of less invasion,shorter operative time and less complications.

參考文獻(xiàn)/References:

[1] 王亦璁.骨與關(guān)節(jié)損傷[M].4版.北京:人民衛(wèi)生出版社,2007:587.
[2] 國(guó)家中醫(yī)藥管理局.中醫(yī)病證診斷療效標(biāo)準(zhǔn)[S].南京:南京大學(xué)出版社,1994:170.
[3] d'Aubigné RM,Postel M.Functional results of hip arthroplasty with acrylic prosthesis[J].J Bone Joint Surg Am,1954,36-A(3):451-475.
[4] 劉永強(qiáng),范金鵬,高蘭芳,等.PFNA與DHS治療不穩(wěn)定性股骨粗隆間骨折療效分析[J].實(shí)用骨科雜志,2011,17(8):743.
[5] 王欣,金捷,時(shí)宏富,等.DHS和PFNA治療老年股骨粗隆間骨折的效果比較分析[J].中國(guó)中醫(yī)骨傷科雜志,2012,20(4):32-34.
[6] 邱貴興,戴尅戎.骨科手術(shù)學(xué)[M].3版.北京:人民衛(wèi)生出版社,2005:318.
[7] 王昌吉.DHS內(nèi)固定加壓失常17例報(bào)告[J].中醫(yī)正骨,2011,23(5):39-40.
[8] Dhillon KS,Askander A,Doraismay S.Postoperative deep-vein thrombosis in Asian patients is not a rarity:a prospective study of 88 patients with no prophylaxis[J].J Bone Joint Surg Br,1996,78(3):427-430.
[9] 曲洪雪,劉云鵬.骨科深靜脈血栓形成危險(xiǎn)因素及發(fā)病機(jī)制的研究進(jìn)展[J].中國(guó)矯形外科雜志,2009,17(2):110-112.

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更新日期/Last Update: 1900-01-01