微创治疗老年不稳定股骨转子间骨折伴骨质疏松症的回顾性研究

发布时间：2018-07-04 21:30

本文选题：骨质疏松性骨折 + 股骨骨折　；参考：《解放军医学杂志》2017年08期

【摘要】：目的探讨微创内固定治疗老年骨质疏松不稳定股骨转子间骨折的方法及疗效。方法回顾性分析2009年1月-2015年9月采用Intertan或短重建钉(TAN)内固定微创治疗的112例老年性骨质疏松股骨转子间骨折患者的临床资料。所有患者均结合病史、查体及影像学检查进行诊断,按照AO分型,31-A.1型34例,31-A.2型61例,31-A.3型17例。对手术时间、透视时间、术中失血量、住院天数、并发症及髋关节功能评分等进行统计分析。结果 112例患者中78例获随访,随访时间3~27个月(平均15个月),其中Intertan组41例,TAN组37例。Intertan组手术时间、透视时间(分别为58.9±6.9、2.70±0.47min)明显短于TAN组(分别为75.6±5.9、4.40±0.47min),术中出血量(107.6±6.7ml)明显低于TAN组(127.8±6.8ml),髋关节Harris评分优良率(73%)高于TAN组(65%),术后并发症发生率(4.9%)低于TAN组(10.8%),差异均有统计学意义(P0.05)。两组住院天数、骨折愈合时间比较差异无统计学意义(P0.05)。结论Intertan和TAN两种微创固定方法治疗不稳定股骨转子间骨折均可取得较好的临床疗效,其中Intertan具有操作简单、固定可靠、出血少、髋关节功能恢复好、并发症少等优点,是治疗老年骨质疏松不稳定股骨转子间骨折的良好选择。
[Abstract]:Objective to explore the method and effect of minimally invasive internal fixation in the treatment of unstable intertrochanteric fracture of the femur. Methods the clinical data of 112 patients with senile osteoporosis intertrochanteric fracture treated with intertan or short reconstruction nail (Tan) from January 2009 to September 2015 were retrospectively analyzed. All the patients were diagnosed with history, physical examination and imaging examination. According to AO classification, there were 34 cases of type 31-A.1 and 61 cases of type 31-A.2, 17 cases of type 31-A.3. The operative time, fluoroscopy time, blood loss during operation, hospitalization days, complications and hip function score were analyzed statistically. Results 78 of 112 patients were followed up for 3 ~ 27 months (mean 15 months). Among them, 41 cases in Intertan group, 37 cases in Tan group, 37 cases in Intertan group, were followed up for 3 ~ 27 months (mean, 15 months). The fluoroscopy time (58.9 卤6.9 卤2.70 卤0.47min) was significantly shorter than that in Tan group (75.6 卤5.9 卤4.40 卤0.47min, respectively), the intraoperative bleeding volume (107.6 卤6.7ml) was significantly lower than that in Tan group (127.8 卤6.8ml), the excellent and good rate of hip Harris score (73%) was higher than that in Tan group (65%), and the incidence of postoperative complications (4.9%) was significantly lower than that in Tan group (10.8%) (P0.05). There was no significant difference in hospitalization days and fracture healing time between the two groups (P0.05). Conclusion Intertan and Tan are two minimally invasive fixation methods for unstable intertrochanteric fracture of femur. Intertan has the advantages of simple operation, reliable fixation, less bleeding, good recovery of hip joint function and less complications. It is a good choice for the treatment of unstable femoral intertrochanteric fracture.
【作者单位】：浙江省立同德医院创伤骨科;
【基金】：浙江省自然科学基金(LY13H060011)~~
【分类号】：R580;R687.3

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