Du Gangqiang, Wang Zhigang, Yang Shuye, Jia Long, Li Peng, Zhang Kai, Jiang Jianhao
Department of Orthopedics Trauma, Binzhou Medical University Hospital, Binzhou Shandong, 256603, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Apr 15;34(4):469-474. doi: 10.7507/1002-1892.201908120.
To investigate the effectiveness and advantages of skeletal tractor in closed reduction and proximal femoral nail antirotation (PFNA) internal fixation of intertrochanteric fracture compared with traction table.
The clinical data of 86 patients with intertrochanteric fractures, who were treated with closed reduction and PFNA internal fixation between October 2016 and March 2018 and met the selection criteria, was retrospectively analysed. Among them, 44 cases were treated with skeletal tractor (trial group) and 42 cases were treated with traction table (control group). There was no significant difference between the two groups in gender, age, cause of injury, fracture side, AO classification, and degree of osteoporosis ( >0.05). The preoperative position time, operation time, intraoperative fluoroscopy times, intraoperative blood loss, fracture healing time, intraoperative and postoperative complications, and postoperative Harris score were compared between the two groups.
The operation was successfully completed in both groups. Compared with the control group, the patients in the trial group had shorter preoperative position time and operation time, fewer intraoperative fluoroscopy times, and less intraoperative blood loss ( <0.05). The patients were followed up 12-21 months in trial group (mean, 14.2 months) and 12-22 months in control group (mean, 14.3 months). Venous thrombosis of lower extremity occurred in 8 patients (3 cases of trial group and 5 cases of control group) after operation. Internal fixation failure occurred in 5 patients (2 cases of trial group and 3 cases of control group) during 1 year after operation. All fractures healed except for those with internal fixation failure, the fracture healing time was (11.6±2.9) weeks in trial group and (12.4±3.6) weeks in control group; and there was no significant difference between the two groups ( =1.250, =0.214). At 1 year after operation, Harris score of the trial group was 86.2±5.9 and that of the control group was 84.1±6.1. There was no significant difference between the two groups ( =1.768, =0.080).
Compared with traction table, skeletal tractor in closed reduction and PFNA internal fixation of intertrochanteric fracture can significantly shorten the preoperative position time and operation time, reduce the intraoperative fluoroscopy times, improve the operation efficiency, and have similar effectiveness.
探讨与牵引床相比，骨牵引器在股骨转子间骨折闭合复位及股骨近端抗旋髓内钉（PFNA）内固定中的有效性及优势。
回顾性分析2016年10月至2018年3月期间86例接受闭合复位及PFNA内固定且符合入选标准的股骨转子间骨折患者的临床资料。其中，44例采用骨牵引器治疗（试验组），42例采用牵引床治疗（对照组）。两组在性别、年龄、受伤原因、骨折侧别、AO分型及骨质疏松程度方面差异无统计学意义（>0.05）。比较两组术前摆位时间、手术时间、术中透视次数、术中出血量、骨折愈合时间、术中和术后并发症以及术后Harris评分。
两组手术均顺利完成。与对照组相比，试验组患者术前摆位时间和手术时间更短，术中透视次数更少，术中出血量更少（<0.05）。试验组患者随访12 - 21个月（平均14.2个月），对照组随访12 - 22个月（平均14.3个月）。术后8例患者发生下肢静脉血栓形成（试验组3例，对照组5例）。术后1年内5例患者发生内固定失败（试验组2例，对照组3例）。除内固定失败的骨折外，所有骨折均愈合，试验组骨折愈合时间为（11.6±2.9）周，对照组为（12.4±3.6）周；两组差异无统计学意义（=1.250，=0.214）。术后1年，试验组Harris评分为86.2±5.9，对照组为84.1±6.1。两组差异无统计学意义（=1.768，=0.080）。
与牵引床相比，骨牵引器在股骨转子间骨折闭合复位及PFNA内固定中可显著缩短术前摆位时间和手术时间，减少术中透视次数，提高手术效率，且疗效相似。
