顺势双向牵引复位治疗不稳定性股骨粗隆间骨折的疗效分析
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摘要
目的探讨顺势双向牵引复位治疗不稳定性股骨粗隆间骨折的疗效。方法选自本科2016年6月至2017年12月收治的不稳定性股骨粗隆间骨折48例,其中,男28例,女20例;年龄24～86岁,平均65岁;随机分成两组,采用顺势双向牵引复位器复位25例,采用牵引床牵引复位23例,手术选择股骨近端髓内钉固定,观察两组病人的手术时间、骨折复位时间、骨折闭合复位率、术中出血量、透视时间、骨折愈合时间及末次随访髋关节功能。结果两组病人均获得随访,随访时间8～18个月,平均14个月。两组病人中,手术时间、骨折复位时间、骨折闭合复位率、术中出血量、透视时间及末次随访髋关节功能(Harris评分)比较差异有统计学意义(P<0.05),而骨折愈合时间比较差异无统计学意义(P>0.05)。结论对于不稳定性股骨粗隆间骨折,选用顺势双向牵引复位器复位骨折端,骨折闭合复位率高、手术时间短、术中透视的次数少及时间短、术后并发症少、髋关节功能恢复良好,值得在临床上推广。
Objective To explore the effect of homeopathic bidirectional-traction reduction device in the treatment of unstable intertrochanteric fracture of femur.Methods There were 48 cases of unstable intertrochanteric fractures since June2016 to December 2017 in our department,including 28 cases of males and 20 cases of females,aged 24 ～ 86 years,with an average of 65 years old.They were divided into two groups at random,using homeopathic bidirectional-traction reduction device were 25 cases,using traction bed traction reduction were 23 cases.All fractures were fixed with prosimal femoral nail antirotation.Observing two groups of patients operation time,fracture reduction time,fracture closed reduction rate,intraoperative blood loss,the perspective of time,fracture healing time and the last follow-up of hip joint function.Results All patients in both groups were followed up for 8 ～ 18 months,with an average of 14 months.According to two groups of patients,the operation time,fracture reduction time,fracture closing perspective of reset rate,intraoperative blood loss,time of fluoroscopy and hip function at the last follow-up(Harris score),the comparison difference were statistically significant(P<0.05),and fracture healing time is no statistical significance(P>0.05).Conclusion The unstable intertrochanteric fractures were fixed by homeopathic bidirectional-traction reduction device,which cloud improve the chances of closed reduction of fractures,short operation time,reduce the number and time of intraoperative fluoroscopy,reduce postoperative complications,improve hip function,which are worth popularized in clinic.
Objective To explore the effect of homeopathic bidirectional-traction reduction device in the treatment of unstable intertrochanteric fracture of femur.Methods There were 48 cases of unstable intertrochanteric fractures since June2016 to December 2017 in our department,including 28 cases of males and 20 cases of females,aged 24 ～ 86 years,with an average of 65 years old.They were divided into two groups at random,using homeopathic bidirectional-traction reduction device were 25 cases,using traction bed traction reduction were 23 cases.All fractures were fixed with prosimal femoral nail antirotation.Observing two groups of patients operation time,fracture reduction time,fracture closed reduction rate,intraoperative blood loss,the perspective of time,fracture healing time and the last follow-up of hip joint function.Results All patients in both groups were followed up for 8 ～ 18 months,with an average of 14 months.According to two groups of patients,the operation time,fracture reduction time,fracture closing perspective of reset rate,intraoperative blood loss,time of fluoroscopy and hip function at the last follow-up(Harris score),the comparison difference were statistically significant(P<0.05),and fracture healing time is no statistical significance(P>0.05).Conclusion The unstable intertrochanteric fractures were fixed by homeopathic bidirectional-traction reduction device,which cloud improve the chances of closed reduction of fractures,short operation time,reduce the number and time of intraoperative fluoroscopy,reduce postoperative complications,improve hip function,which are worth popularized in clinic.
引文
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[4]王煜,李志君,郑玉鹏,等. PFNA内固定治疗老年骨质疏松性股骨粗隆间骨折的疗效分析[J].生物骨科材料与临床研究,2017,14(4):20-23.
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[9]陈伟,魏宁,杜晨光,等.顺势双反牵引复位和牵引床复位对手术治疗老年股骨转子间骨折疗效的影响[J].中华创伤杂志,2017, 33(4):332-337.
[10]叶丹丹,李升,侯志勇,等.牵引复位器治疗四肢长骨骨折的生物力学特性分析[J].河北医科大学学报,2017,38(10):1229-1231.
[11]常恒瑞,于沂阳,邢欣,等.顺势牵引微创治疗胫骨平台骨折[J].中华关节外科杂志, 2017, 11(1):23-27.
[12]于沂阳,常恒瑞,郑占乐,等.顺势互动复位技术治疗难复性股骨颈骨折[J].中华创伤杂志, 2017, 33(7):596-601.
[13]陆伟成,罗振东,张建明,等.内侧皮质损伤对老年股骨粗隆间骨折术后疗效的影响[J].生物骨科材料与临床研究,2016,13(4):78-80.
[2]姬晨妮,陈伟,朱燕宾,等.京津唐地1583例老年股骨转子间骨折流行病学特征分析[J/CD].中华老年骨科与康复电子杂志,2015, 1(1):45-49.
[3] Zhang Y. Clinical Epidemiology of Orthopaedic Trauma[M]. Clinicalepidemiology of orthopedic trauma Thieme, 2016.
[4]王煜,李志君,郑玉鹏,等. PFNA内固定治疗老年骨质疏松性股骨粗隆间骨折的疗效分析[J].生物骨科材料与临床研究,2017,14(4):20-23.
[5]史风雷,陈剑,王宝山,等.低位股骨转子间骨折闭合复位的手术技巧[J].中国矫形外科杂志, 2017, 25(1):79-82.
[6] T. Madhu,R. Dunsmuir. Sensory neurapraxip of the foot after leg-Traction on fracture table[J]. Injury Extra, 2005, 36(7):306-307.
[7] Topliss CJ, Webb WR, Rabin S. Interface pressure produced by the tractionpost on a standard orthopaedic table[J]. Injury, 2001, 32(9):689-691.
[8] Chen W, Zhang T, Wang J, et al. Minimally invasive treatment ofdisplaced femoral shaft fractures with a rapid reductor and intra-medullary nail fixation[J]. Intorthop, 2016, 40(1):167-172.
[9]陈伟,魏宁,杜晨光,等.顺势双反牵引复位和牵引床复位对手术治疗老年股骨转子间骨折疗效的影响[J].中华创伤杂志,2017, 33(4):332-337.
[10]叶丹丹,李升,侯志勇,等.牵引复位器治疗四肢长骨骨折的生物力学特性分析[J].河北医科大学学报,2017,38(10):1229-1231.
[11]常恒瑞,于沂阳,邢欣,等.顺势牵引微创治疗胫骨平台骨折[J].中华关节外科杂志, 2017, 11(1):23-27.
[12]于沂阳,常恒瑞,郑占乐,等.顺势互动复位技术治疗难复性股骨颈骨折[J].中华创伤杂志, 2017, 33(7):596-601.
[13]陆伟成,罗振东,张建明,等.内侧皮质损伤对老年股骨粗隆间骨折术后疗效的影响[J].生物骨科材料与临床研究,2016,13(4):78-80.