改良切口抗旋髓内钉置入术治疗股骨转子间骨折

doi:10.13418/j.issn.1001-165x.2022.3.16

摘要/Abstract

摘要： 目的与标准切口比较，探讨改良切口置入股骨近端防旋髓内钉（proximal femoral nail antirotation，PFNA）对股骨转子间骨折患者的疗效。方法纳入2017年1月~ 2018年12月闭合复位PFNA内固定术治疗的股骨转子间骨折患者，采用改良小切口手术的患者48例，标准切口手术患者38例。记录并比较两组患者手术时长、C臂透视次数、近端切口长度、手术出血量、住院时间、术后1年Harris髋关节评分及Charnley评分，评价手术疗效。结果两组患者性别构成和平均年龄无统计学差异（P>0.05），住院时间无统计学差异（P>0.05）；改良切口组切口长度及手术时间较短，出血量及术中透视次数减少，术后1年随访Harris及Charnley评分均高于标准切口组，差异有统计学意义（P<0.05）。结论改良切口的PFNA置入手术具有透视次数较少、手术时间较短、手术切口较小、出血量较少、手术损伤较小的优点，值得推广。

关键词: 股骨转子间骨折, , , 改良切口, , , 微创, , , 股骨近端髓内钉

Abstract: Objective　To explore the efficacy of modified incision placement PFNA for patients with intertrochanteric fracture.　Methods　The study included 86 patients with intertrochanteric fracture who underwent closed reduction and PFNA internal fixation from January 2017 to December 2018. There were 48 patients with modified minor incision surgery; 38 patients with standard incision surgery.The length of operation, C-arm fluoroscopy times, length of proximal incision, operative blood loss, length of hospital stay, and 1 year after operation were recorded and evaluated using Harris score and Charnley score in both groups. Results ① There were no significant differences in the gender composition and mean age of the included patients (P>0.05); ② The length of hospital stay between the two groups was not significantly different (P>0.05); ③ The modified incision group had a shorter incision length and operation time, blood loss and intraoperative fluoroscopy times were reduced, and the Harris score and Charnley score were higher than those of the standard incision group at 1-year postoperative follow-up. Conclusions The operation of PFNA implantation under the improved incision has the advantages of positioning without fluoroscopy, reduced operation time, smaller surgical incision, less bleeding, and less surgical damage.

Key words: Intertrochanteric fracture of femur, , , Improved incision, , , Minimally invasive, , , Proximal femoral intramedullary nail

中图分类号:

R683.42

陈亮, 胡定祥, 段超, 马晨曦, 邓川芬, 刘敏. 改良切口抗旋髓内钉置入术治疗股骨转子间骨折[J]. 中国临床解剖学杂志, 2022, 40(3): 333-337.

Chen Liang, Hu Dingxiang, Duan Chao, Ma Chenxi , Deng Chuanfen, Liu Min. The treatment of intertrochanteric fractures with modified incision placement of proximal femur antirotational intramedullary nail[J]. Chinese Journal of Clinical Anatomy, 2022, 40(3): 333-337.

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