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中国临床研究:2019,32(9):1203-1209,1214
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新型股骨近端髓内钉治疗老年股骨转子间骨折合并骨质疏松
(中南大学湘雅医学院附属海口医院骨科,海南 海口 570208)
New proximal femoral intramedullary nail for the treatment of intertrochanteric fracture with osteoporosis in the elderly
(Department of Orthopedics,Central South University Xiangya School of Medicine Affiliated Haikou Hospital,Haikou,Hainan 570208,China)
摘要
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投稿时间:2018-12-17   网络发布日期:2019-09-24
中文摘要: 目的探讨对比动力髋螺钉(DHS)与InterTAN髓内钉治疗老年股骨转子间骨折合并骨质疏松的临床疗效。方法取2014年4月至2016年4月114例老年不稳定性股骨转子间骨折合并骨质疏松的患者为研究对象,按照治疗方法不同将患者分为使用InterTAN髓内钉治疗的观察组(57例)和使用DHS的对照组(57例),观察两组患者治疗效果。手术中记录患者手术切口长度、术中失血量、手术时间;术后记录患者伤口引流量及性质、住院时间;随访记录患者骨痂出现时间、骨折愈合时间、开始负重时间、并发症发生情况。髋关节功能判断采用Harris评分。结果观察组患者手术时间、切口长度、失血量、伤口引流量少于对照组,而X线暴露次数多于对照组,差异具有统计学意义(P<0.05,P<0.01);观察组患者住院时间、骨痂出现时间、骨折愈合时间以及开始负重时间方面均短于对照组,差异具有统计学意义(P<0.05,P<0.01);术后6个月的Harris评分优良率,两组无统计学差异(78.95% vs 84.21%,P>0.05);对照组并发症发生率为29.82%,高于观察组的5.26%,尤其是在髋内翻、股骨颈缩短并发症方面,两组并发症发生率差异具有统计学意义(P<0.05)。结论对于老年股骨转子间骨折合并骨质疏松治疗,相比于DHS,InterTAN髓内钉手术时间、失血量、切口长度以及术后引流量均较少;且并发症较少。因此InterTAN髓内钉比DHS更适用于合并有骨质疏松的老年股骨转子间骨折。
Abstract:Objective To compare the clinical efficacy of dynamic hip screw(DHS) and InterTAN intramedullary nail in the treatment of intertrochanteric fracture with osteoporosis in elderly patients. Methods A total of 114 elderly patients with unstable intertrochanteric fracture of femur complicated with osteoporosis from April 2014 to April 2016 were selected as subjects.According to different treatment methods,the patients were divided into observation group (57 cases,treated with InterTAN intramedullary nail) and control group (57 cases,treated with DHS).The therapeutic effects of the two groups were observed.The length of incision,blood loss and operation time were recorded during the operation;the drainage volume and nature of the wound and the length of hospitalization were recorded after the operation;and the callus appearance time,fracture healing time,beginning weight-bearing time and complications were recorded during the follow-up.Harris score was used to evaluate hip function. Results The operation time,incision length,blood loss and wound drainage of the observation group were less than those of the control group,while the number of X-ray exposure was more than that of the control group (all P<0.05).The hospitalization time,callus appearance time,fracture healing time and weight-bearing time of patients in the observation group were significantly shorter than those in the control group (all P<0.05).There was no significant difference in Harris score between the two groups at 6 months after operation (P>0.05).The incidence of complications in the control group was significantly higher than that in the observation group (29.82% vs 5.26%,P<0.05),especially in coxa vara and femoral neck shortening. Conclusion Compared with DHS,InterTAN intramedullary nail has fewer operative time,blood loss,incision length and postoperative drainage,fewer complications,which is more suitable for intertrochanteric fracture with osteoporosis in the elderly.
文章编号:     中图分类号:R 683.42    文献标志码:A
基金项目:海南省自然科学基金面上项目(830865)
引用文本:
邢晓伟,郭祥.新型股骨近端髓内钉治疗老年股骨转子间骨折合并骨质疏松[J].中国临床研究,2019,32(9):1203-1209,1214.

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