股骨近端防旋髓内钉、Gamma钉和股骨近端解剖板治疗股骨转子间骨折的效果比较分析
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摘要
目的对比分析股骨近端防旋髓内钉、Gamma钉和股骨近端解剖板治疗股骨转子间骨折的临床效果。方法选取我院2014年1月—2016年1月收治的98例股骨转子间骨折患者作为研究对象,根据治疗方案的不同分为股骨近端防旋髓内钉组(A组) 36例、Gamma钉组(B组) 30例及股骨近端解剖板组(C组)32例。比较3组患者手术指标、术后Harris髋关节功能评分、术后效果及术后并发症发生情况。结果 (1)A组术中出血量、切口长度、手术时间、骨折愈合时间及住院时间均优于B组和C组,B组上述指标亦优于C组,差异均有统计学意义(P<0.05或P<0.01);(2)手术后,3组患者Harris髋关节功能评分均提高(P<0.01),但3组患者间Harris髋关节功能评分比较差异无统计学意义(P> 0.05);(3)术后优良率A组> B组>C组,差异均有统计学意义(P<0.05或P<0.01);(4)术后并发症发生率A组 Objective To compare the clinical effects of proximal femoral nail antirotation(PFNA),Gamma nail and proximal femoral anatomical plate in the treatment of intertrochanteric fractures(ITF).Methods Ninety-eight patients with ITF admitted to our hospital from January 2014 to January 2016 were selected as subjects.According to the different treatment options,they were divided into PFNA group(group A,n=36),Gamma nail group(group B,n=30) and proximal femoral anatomical plate group(group C,n=32).The surgical condition,postoperative function score of Harris hip,postoperative effect and postoperative complications were compared between the three groups.Results(1)The amount of intraoperative bleeding,length of incision,duration of operation,fracture healing time and length of hospitalization in group A were lower or shorter than those in group B and C,and the above indicators in group B were lower or shorter than those in group C(P<0.05 or P<0.01).(2)After operation,function score of Harris hip were improved in all groups(P<0.01),but there was no significant difference in Harris hip function score between the three groups(P>0.05).(3)The excellent and good rate after operation was the highest in in group A,followed by group B and C(P<0.05 or P<0.01).(4)The incidence rate of postoperative complications in group A was the lowest,followed by group B and C(P<0.05 or P<0.01).Conclusion PFNA has a good clinical effect in the treatment of ITF,which can effectively improve the surgical index and postoperative joint function,and has a certain positive impact on postoperative recovery.
引文
[1]苏世先,刘前前,刘真.半髋关节置换与防旋型股骨近端髓内钉治疗高龄不稳定型股骨粗隆间骨折的效果比较[J].实用临床医药杂志,2016,20(3):118-120.
[2]刘潮坚,蔡拉加,石昭宏,等.半髋置换与股骨近端防旋髓内钉治疗高龄不稳定股骨转子间骨折疗效比较[J].实用骨科杂志,2016,22(6):556-558.
[3]王刚,李树东,吕雪松,等.PFNA解剖钢板与DHS治疗股骨粗隆间骨折合并老年骨质疏松症患者的疗效对比研究[J].河北医学,2016,22(4):606-609.
[4]应霁翀,刘观燚,张勇,等.三种不同内固定方式治疗股骨转子间骨折术后隐性失血及血栓形成的比较[J].中华创伤骨科杂志,2016,18(5):442-446.
[5]胡云根,韩雷,方伟利,等.解剖型锁定钢板及Gamma钉治疗伴有外侧壁骨折股骨转子间骨折的病例对照研究[J].中国骨伤,2016,29(6):496-501.
[6]袁士明,史晓鹏,王素春,等.不同类型股骨转子间骨折内固定选择及疗效分析[J].江苏大学学报(医学版),2011,21(6):529-531.
[7]陈涤新.PFNA内固定与PFLP治疗股骨转子间骨折的疗效对比[J].检验医学与临床,2017,14(20):3114-3116.
[8]石利涛,周维娜,刘彦博,等.PFNA与股骨近端解剖锁定板治疗股骨转子间骨折围手术期失血量对比研究[J].实用老年医学,2017,31(3):280-282.
[9]胡勇斌,殷利民,傅强,等.动力髋螺钉与股骨近端防旋髓内钉治疗老年股骨转子间骨折的近中期疗效比较[J].实用临床医药杂志,2016,20(19):104-105,110.
[10]侯勇,李经坤,司萌,等.PFNA治疗老年股骨粗隆间骨折临床疗效分析[J].创伤外科杂志,2017,19(3):164-168.
[11]杨登峰,阮文辉,谢鹏,等.重组人骨保护素对激素性股骨头坏死患者骨密度及髋关节Harris评分的影响[J].现代生物医学进展,2016,16(16):3108-3111.
[12]罗殿中,张洪,程徽,等.简化国际髋关节评分量表在髋臼周围截骨术评价中的应用69例报告[J].中国骨与关节杂志,2016,5(2):105-108.
[13]陆道望,陈述列,罗杰,等.股骨近端防旋髓内钉治疗老年股骨转子间骨折疗效观察[J].海南医学,2016,27(11):1870-1871,1872.
[14]华荣,顾军,倪英杰,等.股骨近端防旋髓内钉、加压滑动鹅头钉和股骨近端锁定加压钢板治疗股骨粗隆间骨折的疗效比较[J].安徽医药,2016,20(9):1687-1690.
[15]吴长明,王立山,侯福安.股骨近端解剖锁定钢板与股骨近端防旋髓内钉治疗股骨转子间骨折的有效性和安全性[J].医学综述,2017,23(3):609-612,616.
[16]冷云飞,于沈敏,蔡兵,等.防旋股骨近端髓内钉微创内固定治疗老年股骨转子间骨折[J].临床骨科杂志,2016,19(4):469-470.
[17]易碧龙,黄哲元,刘好源.PFNA治疗高龄骨质疏松股骨粗隆间骨折器械失效后翻修一例[J].临床误诊误治,2013,26(3):40-42.
[18]张立峰,林创鑫,冯卫,等.斯氏针辅助复位在股骨近端防旋髓内钉固定治疗不稳定型股骨转子间骨折中的应用[J].中华创伤骨科杂志,2017,19(2):127-132.
[19]李平,肖善富,陶瑞宝.股骨近端防旋髓内钉和股骨近端锁定钢板治疗老年股骨转子间骨折[J].临床骨科杂志,2016,19(6):727-729.
[20]李群,吴守群,陈优民,等.近端防旋髓内钉与近端锁定钢板治疗老年股骨转子间不稳定骨折的疗效对比分析[J].现代生物医学进展,2016,16(21):4131-4133.
[21]徐小峰,魏长宝,黄永辉,等.闭合复位锁定钢板外置和切开复位锁定钢板内置治疗SandersⅡ、Ⅲ型跟骨骨折的临床对照研究[J].江苏大学学报(医学版),2016,26(3):240-243.
[22]林俊涛,姚志保,程辉.股骨近端防旋髓内钉治疗老年股骨转子间骨折[J].安徽医学,2016,37(5):560-562.
[23]Futamura K,Baba T,Homma Y,et al.New classification focusing on the relationship between the attachment of the iliofemoral ligament and the course of the fracture line for intertrochanteric fractures[J].Injury,2016,47(8):1685-1691.
[24]谢行思,黄永辉,吴兴源.股骨近端锁定钢板与股骨近端抗旋髓内钉治疗股骨转子间骨折的疗效比较[J].中国中西医结合外科杂志,2016,22(4):340-343.
[25]国庆.股骨近端防旋髓内钉与股骨近端解剖型锁定钢板治疗老年股骨粗隆间骨折的临床效果研究[J].实用临床医药杂志,2017,21(3):138-140.
[2]刘潮坚,蔡拉加,石昭宏,等.半髋置换与股骨近端防旋髓内钉治疗高龄不稳定股骨转子间骨折疗效比较[J].实用骨科杂志,2016,22(6):556-558.
[3]王刚,李树东,吕雪松,等.PFNA解剖钢板与DHS治疗股骨粗隆间骨折合并老年骨质疏松症患者的疗效对比研究[J].河北医学,2016,22(4):606-609.
[4]应霁翀,刘观燚,张勇,等.三种不同内固定方式治疗股骨转子间骨折术后隐性失血及血栓形成的比较[J].中华创伤骨科杂志,2016,18(5):442-446.
[5]胡云根,韩雷,方伟利,等.解剖型锁定钢板及Gamma钉治疗伴有外侧壁骨折股骨转子间骨折的病例对照研究[J].中国骨伤,2016,29(6):496-501.
[6]袁士明,史晓鹏,王素春,等.不同类型股骨转子间骨折内固定选择及疗效分析[J].江苏大学学报(医学版),2011,21(6):529-531.
[7]陈涤新.PFNA内固定与PFLP治疗股骨转子间骨折的疗效对比[J].检验医学与临床,2017,14(20):3114-3116.
[8]石利涛,周维娜,刘彦博,等.PFNA与股骨近端解剖锁定板治疗股骨转子间骨折围手术期失血量对比研究[J].实用老年医学,2017,31(3):280-282.
[9]胡勇斌,殷利民,傅强,等.动力髋螺钉与股骨近端防旋髓内钉治疗老年股骨转子间骨折的近中期疗效比较[J].实用临床医药杂志,2016,20(19):104-105,110.
[10]侯勇,李经坤,司萌,等.PFNA治疗老年股骨粗隆间骨折临床疗效分析[J].创伤外科杂志,2017,19(3):164-168.
[11]杨登峰,阮文辉,谢鹏,等.重组人骨保护素对激素性股骨头坏死患者骨密度及髋关节Harris评分的影响[J].现代生物医学进展,2016,16(16):3108-3111.
[12]罗殿中,张洪,程徽,等.简化国际髋关节评分量表在髋臼周围截骨术评价中的应用69例报告[J].中国骨与关节杂志,2016,5(2):105-108.
[13]陆道望,陈述列,罗杰,等.股骨近端防旋髓内钉治疗老年股骨转子间骨折疗效观察[J].海南医学,2016,27(11):1870-1871,1872.
[14]华荣,顾军,倪英杰,等.股骨近端防旋髓内钉、加压滑动鹅头钉和股骨近端锁定加压钢板治疗股骨粗隆间骨折的疗效比较[J].安徽医药,2016,20(9):1687-1690.
[15]吴长明,王立山,侯福安.股骨近端解剖锁定钢板与股骨近端防旋髓内钉治疗股骨转子间骨折的有效性和安全性[J].医学综述,2017,23(3):609-612,616.
[16]冷云飞,于沈敏,蔡兵,等.防旋股骨近端髓内钉微创内固定治疗老年股骨转子间骨折[J].临床骨科杂志,2016,19(4):469-470.
[17]易碧龙,黄哲元,刘好源.PFNA治疗高龄骨质疏松股骨粗隆间骨折器械失效后翻修一例[J].临床误诊误治,2013,26(3):40-42.
[18]张立峰,林创鑫,冯卫,等.斯氏针辅助复位在股骨近端防旋髓内钉固定治疗不稳定型股骨转子间骨折中的应用[J].中华创伤骨科杂志,2017,19(2):127-132.
[19]李平,肖善富,陶瑞宝.股骨近端防旋髓内钉和股骨近端锁定钢板治疗老年股骨转子间骨折[J].临床骨科杂志,2016,19(6):727-729.
[20]李群,吴守群,陈优民,等.近端防旋髓内钉与近端锁定钢板治疗老年股骨转子间不稳定骨折的疗效对比分析[J].现代生物医学进展,2016,16(21):4131-4133.
[21]徐小峰,魏长宝,黄永辉,等.闭合复位锁定钢板外置和切开复位锁定钢板内置治疗SandersⅡ、Ⅲ型跟骨骨折的临床对照研究[J].江苏大学学报(医学版),2016,26(3):240-243.
[22]林俊涛,姚志保,程辉.股骨近端防旋髓内钉治疗老年股骨转子间骨折[J].安徽医学,2016,37(5):560-562.
[23]Futamura K,Baba T,Homma Y,et al.New classification focusing on the relationship between the attachment of the iliofemoral ligament and the course of the fracture line for intertrochanteric fractures[J].Injury,2016,47(8):1685-1691.
[24]谢行思,黄永辉,吴兴源.股骨近端锁定钢板与股骨近端抗旋髓内钉治疗股骨转子间骨折的疗效比较[J].中国中西医结合外科杂志,2016,22(4):340-343.
[25]国庆.股骨近端防旋髓内钉与股骨近端解剖型锁定钢板治疗老年股骨粗隆间骨折的临床效果研究[J].实用临床医药杂志,2017,21(3):138-140.