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InterTan髓内钉治疗老年股骨转子间冠状面骨折的病例对照研究

[Case-control study on InterTan intramedullary nail in treating coronal femoral intertrochanteric fracture in elderly].

作者信息

Zhu Jia-Fu, Xu Wei-Xing, Liu Hong

机构信息

Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China;

Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2016 Dec 25;29(12):1130-1134. doi: 10.3969/j.issn.1003-0034.2016.12.013.

Abstract

OBJECTIVE

To compare clinical effect of closed reduction and limited open reduction and internal fixation with InterTan intramedullary nail in treating elderly patients with coronal femoral intertrochanteric fracture.

METHODS

From January 2013 to December 2015, 23 elderly patients with coronal femoral intertrochanteric fracture were divided into two groups according to different ways of reduction to be retrospectively analyzed. There were 12 cases with closed reduction and internal fixation with InterTan intramedullary nail group (closed reduction group), including 7 males and 5 females with an average age of(63.6±12.1) years old; while 11 cases with limited open reduction and internal fixation with InterTan intramedullary nail group(limited reduction group), including 6 males and 5 females with an average of (60.8±12.5) years old. Intraoperative blood loss, fluoroscopy, operative time, postoperative complications, hospital stays and bone healing time were observed and compared. Harris score of hip joint at 1 year after operation was compared between two groups.

RESULTS

The incisions between two groups were healed well at stage I, and no complications occurred. One case was died during following-up, and 22 cases were obtained following-up from 12 to 23 months with an average of 13.6 months. There were significant difference in operative time, intraoperative blood loss and fluoroscopy(<0.05); while no difference in hospital stays, postoperative complications(>0.05). Harris score at 1 year after operation in open reduction group was(83.9±8.9), and(83.4±9.1) in closed reduction group without significant difference between two groups(>0.05).

CONCLUSIONS

Closed reduction and limited open reduction with InterTan intramedullary nail internal fixation for the treatment of intertrochanteric femoral coronal fractures could achieve good clinical effects, the former to receive more radiation dose, with less trauma;while the latter has disadvantages of long blood bleeding and operative time, but could obtain high quality of reduction.

摘要

目的

比较闭合复位与有限切开复位InterTan髓内钉内固定治疗老年股骨转子间冠状面骨折的临床效果。

方法

回顾性分析2013年1月至2015年12月期间收治的23例老年股骨转子间冠状面骨折患者,根据复位方式不同分为两组。闭合复位InterTan髓内钉内固定组(闭合复位组)12例,男7例,女5例,平均年龄(63.6±12.1)岁;有限切开复位InterTan髓内钉内固定组(有限切开复位组)11例,男6例,女5例,平均年龄(60.8±12.5)岁。观察并比较两组患者术中出血量、透视次数、手术时间、术后并发症、住院时间及骨折愈合时间。比较两组患者术后1年髋关节Harris评分。

结果

两组切口均Ⅰ期愈合,无并发症发生。随访期间死亡1例,22例获得随访,随访时间12~23个月,平均13.6个月。两组手术时间、术中出血量及透视次数比较差异有统计学意义(<0.05);住院时间、术后并发症比较差异无统计学意义(>0.05)。切开复位组术后1年Harris评分为(83.9±8.9)分,闭合复位组为(83.4±9.1)分,两组比较差异无统计学意义(>0.05)。

结论

闭合复位与有限切开复位InterTan髓内钉内固定治疗股骨转子间冠状面骨折均可取得良好临床效果,前者辐射剂量大,创伤小;后者出血及手术时间长,但复位质量高。

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