Inter TAN治疗股骨粗隆间骨折时内侧皮质正性支撑复位临床效果的分析

发布时间：2018-03-24 03:06

  本文选题：股骨粗隆间骨折　切入点：Inter　出处：《大连医科大学》2017年硕士论文

【摘要】：[目的]分析内侧皮质正性支撑复位在联合加压交锁髓内钉系统(tri Gen intertan hip fracture nailing system,Inter TAN)内固定治疗股骨粗隆间骨折时临床效果的影响。[方法]回顾性分析我院2013年2月至2016年1月采用Inter TAN治疗的不稳定型顺向股骨粗隆间骨折(AO/OTA 31A2型)患者68例,其中男30例,女38例,年龄61-84岁,平均(70.43±6.058)岁。依据术后即刻标准正侧位X线片上近端头颈侧骨块内侧皮质与远端股骨干内侧皮质的位置关系分为3组:内侧皮质正性支撑(36例),内侧皮质中性支撑(24例),内侧皮质负性支撑(8例)。比较三组患者的术前一般临床资料,手术时长、术中出血量、住院时间、术后并发症发生率、尖顶距(TAD)、颈干角、股骨颈长度变化及术后6个月随访时髋关节Harris评分等。[结果]三组患者在年龄、性别比、手术时长、术中出血量、住院时间、尖顶距等方面无统计学差异(P0.05)。术后3个月颈干角及股骨颈长度丢失内侧皮质正性支撑组低于负性支撑组,差别有统计意义(P0.01)。术后随访6个月髋关节Harris评分内侧皮质正性支撑组优良率高于负性支撑组,而并发症发生率则较低,差别有统计意义(P0.05)。[结论]内侧皮质正性支撑复位可使头颈骨块与股骨干之间获得更稳定的接触面,为骨折愈合提供良好的生物力学条件,可以让患者更早下地进行功能锻炼,减少术后并发症的发生。
[Abstract]:[Objective] analysis of the medial cortex positive support reduction in compression interlocking intramedullary nail system (tri Gen intertan hip fracture nailing system, Inter TAN)]. Methods in the treatment of femoral intertrochanteric fracture clinical effect of unstable type of retrospective analysis of our hospital from February 2013 to January 2016 by Inter TAN for the CIS the fracture of femoral intertrochanteric (AO/OTA 31A2) 68 cases, male 30 cases, female 38 cases, age 61-84 years, average (70.43 + 6.058) years old. According to standard and immediate postoperative X-ray on the proximal side of head and neck bone medial cortex position between the distal femoral medial cortex divided into 3 groups: the medial cortex is supporting the medial cortex (36 cases), neutral support (24 cases), the medial cortex negative support (8 cases). Patients in the preoperative clinical data in three groups, operation time, amount of bleeding, hospitalization time, postoperative complications tip. From the top of the neck shaft angle (TAD), and 6 months follow-up changes and postoperative length of femoral neck hip joint Harris score. Results: three groups of patients in age, sex ratio, operation time, bleeding volume, operation time, no significant difference from the aspects of spire (P0.05) 3. April collodiaphyseal angle and femoral neck length loss of medial cortex positive support group was lower than that of negative support group, the difference was statistically significant (P0.01). After 6 months of follow-up Harris hip score of the medial cortex positive support group was higher than that of negative support group, and the complication rate is low, poor don't have statistical significance (P0.05). Conclusion] the medial cortex is supporting reduction makes it possible to obtain a more stable contact surface between bone and femoral neck fracture healing, to provide biomechanical conditions are good, can let the patient to early functional exercise, reduce the incidence of postoperative complications.

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3
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本文编号：1656414