两种方法在评价股骨转子间骨折术中复位效果的对比研究

发布时间：2018-04-24 00:17

本文选题：转子间骨折 + PFNA　；参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:随着我国老龄化进展,转子间骨折越来越常见,这与老年人骨质疏松有关[1],且目前股骨转子间骨折多采用手术治疗。在术中复位时,用传统X线投照方法难以准确地反映股骨颈前倾角的真正角度,而股骨颈前倾角的偏差或偏小会影响骨折端及髋关节的稳定性。本研究的目的在于寻找一种既为简便、更为准确反映股骨颈转子间骨折复位后的前倾角的X线投照方法,用以指导术中骨折复位,缩短手术时间,提高手术成功率。方法:本研究分为2个部分,第一部为4位健康人(无陈旧及新发骨折,无骨病的2男2女,双侧)进行预实验,用CT法、传统投照方法、自拟方法共3种方法测量股骨颈前倾角,后2种方法测量的股骨颈前倾角与CT法测量的进行对比,得出了自拟方法较传统方法更为准确的初步结论。第二部分的研究对象为患者,对我院31例患者(患侧)在术中分别使用传统投照和自拟方法两种方法进行投照,用SPSS22.0将得出的股骨颈前倾角分别与CT法测量的前倾角进行统计分析,比较两种方法在测量股骨颈前倾角的差异性。结果:预试验中,4名健康人(双侧)中,传统方法及自拟方法测量的前倾角均比CT测量大,后者的差值较前者小。在31例患者(患侧)中,传统投照方法、自拟方法与CT测量的前倾角对比均有统计学意义(P=0.00,P=0.007);传统方法与自拟方法测量的前倾角对比有统计学意义(P=0.00),说明自拟方法较传统方法测量的股骨颈前倾角更为接近CT测量的实际前倾角。结论:预实验及患者身上的实验均表明,自拟方法较传统方法测量的股骨颈前倾角更为接近CT测量的真实前倾角,说明自拟方法在评价术中骨折端复位情况明显优于传统方法,在临床中有较好的应用价值。
[Abstract]:Objective: with the progress of aging in China, intertrochanteric fracture is becoming more and more common, which is related to [1] in the elderly with osteoporosis, and at present, most of the intertrochanteric fractures are treated with surgical treatment. The purpose of this study is to find a method of X-ray radiography which is simple and accurate to reflect the reduction of the intertrochanteric fracture of the femoral neck, which is used to guide the reduction of the fracture, shorten the operation time and improve the success rate of the operation. Methods: This study is divided into 2 parts, the first one is 4 healthy people. (no obsolete and new fracture, 2 men and 2 women without osteopathy, bilateral) was pretested. The CT method, traditional projection method and self-made method were used to measure the femoral neck obliquity, and the latter 2 methods compared the femoral neck obliquity with the CT method, and the preliminary conclusion that the self-made method was more accurate than the traditional method was obtained. Second parts were obtained. Second parts were obtained. The subjects were patients. 31 patients (affected side) in our hospital were treated with two methods of traditional and self-designed methods. The pretilt angle of the neck of the femur was measured by SPSS22.0 and the angle of the pretilt of the femoral neck was measured by the CT method, and the difference between the two methods in measuring the angle of the femoral neck was compared. Results: 4 in the pre test. In the healthy people (bilateral), the traditional method and the self-made method are all larger than the CT measurement, and the difference of the latter is smaller than that of the former. In the 31 patients (affected side), the traditional method of projection, the self-made method and the CT measurement are statistically significant (P=0.00, P=0.007), and the comparison between the traditional method and the self-made method is statistically significant. Meaning (P=0.00), indicating that the method of self drawing is more close to the actual obliquity of the femoral neck obliquity measured by the traditional method than the traditional method. Conclusion: the pre experiment and the experiment on the patient show that the self-made method is more close to the true obliquity of the CT measurement than the traditional method of the femoral neck tilt angle measured by the traditional method, indicating that the self-made method is used to evaluate the fracture end of the operation. The reduction is obviously better than the traditional method, and has a good application value in clinic.

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

【参考文献】