两种定位法在股骨转子间骨折手术中应用比较

发布时间：2018-05-18 00:42

本文选题：三点定位法 + 普通定位法　；参考：《中国矫形外科杂志》2017年14期

【摘要】：[目的]比较三点定位法和普通定位法在股骨转子间骨折手术中置入股骨颈螺旋刀片的临床效果。[方法]2010年1月~2013年6月共手术治疗股骨转子间骨折患者90例,男48例,女42例,平均年龄(70.50±7.20)岁。骨折按AO分型:A2.1型45例,A2.2型35例,A2.3型10例。按定位方法分为两组,三点组和常规组,每组45例。由同一组医生操作,均采用股骨近端髓内钉(PFNA)固定,但是在置入股骨颈拉力螺钉时方法不同。记录总手术时间、置入螺旋刀片时间、术中出血量、置螺旋刀片曝光次数、尖顶距等指标。[结果]在手术时间[(59.34±9.42)min vs(67.61±12.63)min,P0.01]、置入螺旋刀片时间[(4.58±1.25)min vs(7.82±2.19)min,P0.01]、术中出血量[(92.78±34.09)ml vs(154.01±39.10)ml,P0.01]、曝光次数[(8.84±1.45)vs(14.62±2.91),P0.01]、尖顶距[(16.78±1.55)mm vs(21.91±3.01)mm,P0.01]三点组均明显优于常规组,两组间差异有统计学性意义。90例患者中80例获平均12个月随访(10~15个月),三点组42例,常规组38例。三点组无内置物切出发生,常规组2例患者在术后1月发生螺旋刀片切出。术后半年随访两组髋关节Harris评分差异无统计学意义。[结论]三点定位法较普通定位法更快速、准确。
[Abstract]:[Objective] to compare the clinical effects of inserting the spiral blade of the femur neck in the operation of intertrochanteric fracture of the femur by three point positioning method and common location method. [methods]2010 January ~2013 year June, the operation treatment of femoral intertrochanteric fracture in 90 cases, male 48 cases, 42 women, average age (70.50 + 7.20) years old. Fracture according to AO classification: A2.1 type 45 cases, A2.2 type 35 cases, A2.3 10 cases were divided into two groups, three point group and routine group, 45 cases in each group. The same group of doctors operated with the proximal femur intramedullary nail (PFNA), but the method was different when placing the femoral neck pull screw. The total operation time, the screw blade time, the amount of intraoperative bleeding, the number of spiral blade exposure, the spires and so on were recorded. [results] in the operation time [(59.34 + 9.42) min vs (67.61 + 12.63) min, P0.01], the time [(4.58 + 1.25) min vs (7.82 + 2.19) min, P0.01], the amount of bleeding in the operation [(92.78 + 34.09) ml vs (154.01 + 39.10) ml, P0.01], exposure times) The point group was obviously superior to the conventional group. The difference between the two groups was statistically significant, 80 cases in.90 patients were followed up with an average of 12 months (10~15 months), three points in 42 cases and 38 cases in the conventional group. The three point group had no internal material cut out, and the conventional group 2 patients had the spiral blade cut out in January. The difference of the hip joint Harris score of the two groups after the operation was no more than six months after the operation. [Conclusion] the three point localization method is more rapid and accurate than the common location method.
【作者单位】：济宁医学院附属医院骨科;济宁市鱼台县医院骨科;
【基金】：济宁市科学计划资助项目(编号:济科字[2011]57号;济科字[2015]57-135)
【分类号】：R687.3

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