Liu Yang-Bo, Shen Cui-Hua, Yuan Jian-Dong, Wu Peng, Lang Jun-Zhe, Chen Kai, Chen Lei
The First Affiliated Hospital of Wenzhou University, Wenzhou 325000, Zhejiang, China.
The First Affiliated Hospital of Wenzhou University, Wenzhou 325000, Zhejiang, China;
Zhongguo Gu Shang. 2016 Nov 25;29(11):1033-1039. doi: 10.3969/j.issn.1003-0034.2016.11.012.
To investigate the clinical outcomes of C-arm X-ray fluoroscopy before incision to make assistant lines and insert the guide wire of PFNA and PFNA blade.
From January 1st 2012 to January 1st 2015, 132 intertrochanteric fracture patients of type 31A1 and 31A2 according to AO-classification, were retrospectively analyzed. Among them, 62 patients(14 males and 48 females) aged from 52 to 95 years with a mean age of(69.58±8.55) years in traditional group were operated by traditional procedure, while 70 patients in the skin marking group included 15 males and 55 females aged from 61 to 88 years with a mean age of(71.94±7.64) years, on the basis of the traditional operation method, the assistant line of the body surface and the C-arm X-ray was increased, and the guide pin positioning of the proximal femoral nail and the spiral blade was guided by the auxiliary line in the operation. Operative time, frequency of C-arm fluoroscopy, Harris hip score of the third months after surgery and the complications in both groups were queried for statistical analysis.
In addition to skin making group 1 patients had superficial wound infection complications, all patients were stage I wound healing. All patients were followed up for 3 to 18 months with an average of (6.81±3.07) months. The operative time was significantly reduced in skin marking group (56.16±6.36) minutes compared to traditional group (59.06±9.19) minutes (>=0.035). And the frequency of C-arm fluoroscopy of skin marking group was(25.89±5.81) times which was also significantly reduced compared to traditional group(31.32±9.81) times (<0.001). There was no statistical difference in Harris hip score at 3 months after operation and the complication rate between the two groups(>0.05).
In this study, a simple and easy method of assistant line marking can shorten the operation time and reduce the number of times of operation.
探讨切开前利用C型臂X线透视制作辅助线并插入PFNA及PFNA刀片导针的临床效果。
回顾性分析2012年1月1日至2015年1月1日收治的132例按AO分型为31A1和31A2型的股骨转子间骨折患者。其中传统组62例（男14例，女48例），年龄52～95岁，平均年龄（69.58±8.55）岁，采用传统手术方法；体表标记组70例，男15例，女55例，年龄61～88岁，平均年龄（71.94±7.64）岁，在传统手术方法基础上，增加体表与C型臂X线辅助线，术中通过辅助线引导股骨近端髓内钉及螺旋刀片导针定位。比较两组手术时间、C型臂透视次数、术后3个月Harris髋关节评分及并发症情况并进行统计学分析。
除体表标记组1例患者发生浅表伤口感染并发症外，所有患者切口均Ⅰ期愈合。所有患者均获随访3～18个月，平均（6.81±3.07）个月。体表标记组手术时间（56.16±6.36）分钟，明显短于传统组（59.06±9.19）分钟（P<0.035）；体表标记组C型臂透视次数（25.89±5.81）次，也明显少于传统组（31.32±9.81）次（P<0.001）。两组术后3个月Harris髋关节评分及并发症发生率比较，差异无统计学意义（P>0.05）。
本研究中一种简单易行的辅助线标记方法可缩短手术时间并减少术中透视次数。
