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[1]張威,趙士君,李翔,等.改良“糖果包扎”鋼絲內(nèi)固定聯(lián)合股骨近端防旋髓內(nèi)釘內(nèi)固定治療老年A2型股骨轉(zhuǎn)子間骨折的臨床研究[J].中醫(yī)正骨,2021,33(10):23-28.
　ZHANG Wei,ZHAO Shijun,LI Xiang,et al.A clinical study of modified candy-package wire internal fixation combined with proximal femoral nail antirotation internal fixation for treatment of type A2 femoral intertrochanteric fractures in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(10):23-28.
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改良“糖果包扎”鋼絲內(nèi)固定聯(lián)合股骨近端防旋髓內(nèi)釘內(nèi)固定治療老年A2型股骨轉(zhuǎn)子間骨折的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年10期
頁碼:
23-28
欄目:
臨床研究
出版日期:
2021-10-20

文章信息/Info

Title:
A clinical study of modified candy-package wire internal fixation combined with proximal femoral nail antirotation internal fixation for treatment of type A2 femoral intertrochanteric fractures in the aged
作者:
張威; 趙士君; 李翔; 燕冰
(鄭州市骨科醫(yī)院,河南 鄭州 450052)
Author(s):
ZHANG Wei; ZHAO Shijun; LI Xiang; YAN Bing
Zhengzhou Orthopedics Hospital,Zhengzhou 450052,Henan,China
關(guān)鍵詞:
髖骨折;  轉(zhuǎn)子間骨折;  股骨;  小轉(zhuǎn)子;  老年人;  骨折固定術(shù); 內(nèi);  “糖果包扎”;  骨固定鋼絲;  股骨近端防旋髓內(nèi)釘;  臨床試驗
Keywords:
hip fractures;  intertrochanteric fractures;  femur;  lesser trochanter;  aged;  fracture fixation; internal;  “candy-package”;  bone wires;  proximal femoral nail antirotation;  clinical trial
摘要:
目的:探討改良“糖果包扎”鋼絲內(nèi)固定聯(lián)合股骨近端防旋髓內(nèi)釘(proximal femoral nail antirotation,PFNA)內(nèi)固定治療老年A2型股骨轉(zhuǎn)子間骨折的臨床療效和安全性。方法:回顧性分析32例老年A2型股骨轉(zhuǎn)子間骨折患者的病例資料,將采用改良“糖果包扎”鋼絲內(nèi)固定聯(lián)合PFNA內(nèi)固定治療的患者納入聯(lián)合治療組(19例),將僅采用PFNA內(nèi)固定治療的患者納入單純PFNA內(nèi)固定治療組(13例)。比較2組患者的手術(shù)時間、術(shù)中出血量、骨折愈合時間、Harris髖關(guān)節(jié)評分及并發(fā)癥發(fā)生率。結(jié)果:①一般指標。聯(lián)合治療組患者手術(shù)時間長于單純PFNA內(nèi)固定治療組[(67.3±16.8)min,(50.4±15.2)min,t=0.332,P=0.035]、術(shù)中出血量多于單純PFNA內(nèi)固定治療組[(167±46)mL,(122±23)mL,t=0.447,P=0.015] 、骨折愈合時間短于單純PFNA內(nèi)固定治療組[(11.7±3.3)周,(13.9±2.6)周,t=0.612,P=0.027]。②Harris髖關(guān)節(jié)評分。術(shù)后12個月,聯(lián)合治療組患者Harris髖關(guān)節(jié)評分高于單純PFNA內(nèi)固定治療組[(94.5±3.6)分,(85.4±6.8)分,t=0.022,P=0.015]。③并發(fā)癥發(fā)生率。聯(lián)合治療組均未發(fā)生血管神經(jīng)損傷、切口感染、內(nèi)固定失效、髖內(nèi)翻畸形、下肢短縮畸形等并發(fā)癥; 單純PFNA內(nèi)固定治療組,術(shù)后2個月發(fā)生髖內(nèi)翻畸形1例、螺旋刀片切出股骨頭1例。2組患者并發(fā)癥發(fā)生率比較,差異無統(tǒng)計學意義(χ2=3.118,P=0.077)。結(jié)論:采用改良“糖果包扎”鋼絲內(nèi)固定聯(lián)合PFNA內(nèi)固定治療老年A2型股骨轉(zhuǎn)子間骨折,與單純PFNA內(nèi)固定相比,手術(shù)時間長、術(shù)中出血量多,但骨折愈合快、更有利于髖關(guān)節(jié)功能恢復,二者安全性相當。
Abstract:
Objective:To explore the clinical curative effects and safety of modified candy-package wire internal fixation combined with proximal femoral nail antirotation(PFNA)internal fixation for treatment of type A2 femoral intertrochanteric fractures in the aged.Methods:The medical records of 32 aged patients with type A2 femoral intertrochanteric fractures were analyzed retrospectively.Nineteen patients were treated with modified candy-package wire internal fixation and PFNA internal fixation(combination treatment group),while the others with PFNA internal fixation alone(PFNA internal fixation group).The operative time,intraoperative blood loss,fracture healing time,Harris hip scores and complication incidence were compared between the 2 groups.Results:The operative time was longer,the intraoperative blood loss was more,and the fracture healing time was shorter in combination treatment group compared to PFNA internal fixation group(67.3±16.8 vs 50.4±15.2 minutes,t=0.332,P=0.035; 167±46 vs 122±23 mL,t=0.447,P=0.015; 11.7±3.3 vs 13.9±2.6 weeks,t=0.612,P=0.027).The Harris hip scores were higher in combination treatment group compared to PFNA internal fixation group at 12 months after the surgery(94.5±3.6 vs 85.4±6.8 points,t=0.022,P=0.015).No complications such as neurovascular injury,incision infection,failed internal fixation,coxa vara deformity and lower limb shortening deformity were found in combination treatment group; while the coxa vara deformity(1 case)and spiral blade protrusion from femoral head(1 case)were found in PFNA internal fixation group at 2 months after the surgery.There was no statistical difference in complication incidences between the 2 groups(χ2=3.118,P=0.077).Conclusion:The combination therapy of modified candy-package wire internal fixation and PFNA internal fixation has the disadvantages as longer operative time and more intraoperative blood loss,but advantages as faster fracture healing and better recovery of hip function compared to monotherapy of PFNA internal fixation in treatment of type A2 femoral intertrochanteric fractures in the aged; whereas the two therapies are similar to each other in the safety.

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通訊作者:燕冰 E-mail:[email protected]
更新日期/Last Update: 1900-01-01