Zhang Zenghui, Han Tichao, Li Wei, Zhou Yangyang, Liu Junjun, Li Nannan, Ren Tiantian
Department of Orthopedics, People's Hospital of Linquan County, Linquan Anhui, 236400, P. R. China.
Department of Orthopedics, the First Affiliated Hospital of Ningbo University, Ningbo Zhejiang, 315000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Jan 15;39(1):53-58. doi: 10.7507/1002-1892.202410006.
To investigate the feasibility and effectiveness of the novel bone hook combined with finger-guided technique in the treatment of irreducible intertrochanteric femoral fractures in elderly.
Between January 2021 and August 2023, 23 elderly patients with irreducible intertrochanteric femoral fractures were treated with the novel bone hook combined with finger-guided technique. There were 10 males and 13 females; the age ranged from 68 to 93 years (mean, 76.2 years). The time from injury to operation ranged from 36 to 76 hours (mean, 51.2 hours). According to the classification standard proposed by TONG Dake in 2021, there were 10 cases of typeⅠA, 1 case of typeⅠB, 6 cases of type ⅡA, 4 cases of type ⅡB, and 2 cases of type ⅡC. The operation time, intraoperative blood loss, intraoperative fluoroscopy frequences, and quality of fracture reduction were recorded. The fracture healing time and occurrence of postoperative complications were observed during follow-up. At last follow-up, the Harris scoring system was used to evaluate the hip joint function.
The operation time was 42-95 minutes (mean, 52.1 minutes). The intraoperative blood loss was 40-420 mL (mean, 126.5 mL). Intraoperative fluoroscopy was performed 14-34 times (mean, 20.7 times). According to the criteria proposed by Chang , the quality of fracture reduction was rated as good in 20 cases and acceptable in 3 cases. All patients were followed up 6-20 months (mean, 10.2 months). X-ray film showed that all fractures healed with the healing time of 3.0-5.5 months (mean, 4.0 months). At last follow-up, the Harris score of the hip joint ranged from 82 to 97 points (mean, 90.4 points). Among them, 14 cases were rated as excellent and 9 cases as good. No complication such as coxa vara, cutting of the cephalomedullary nail, nail withdrawal, or nail breakage occurred during follow-up.
The treatment of elderly patients with irreducible intertrochanteric femoral fractures by using the novel bone hook combined with finger-guided technique can achieve high-quality fracture reduction and fixation, and has a good effectiveness.
探讨新型骨钩联合手指引导技术治疗老年难复性股骨粗隆间骨折的可行性及有效性。
2021年1月至2023年8月，采用新型骨钩联合手指引导技术治疗23例老年难复性股骨粗隆间骨折患者。其中男性10例，女性13例；年龄68～93岁，平均76.2岁。受伤至手术时间36～76小时，平均51.2小时。按照童大恺2021年提出的分类标准，ⅠA 型10例，ⅠB型1例，ⅡA型6例，ⅡB型4例，ⅡC型2例。记录手术时间、术中出血量、术中透视次数及骨折复位质量。随访观察骨折愈合时间及术后并发症发生情况。末次随访时采用Harris评分系统评价髋关节功能。
手术时间42～�5分钟，平均52.1分钟。术中出血量40～420毫升，平均126.5毫升。术中透视14～34次，平均20.7次。按照Chang提出的标准，骨折复位质量评为优20例，可3例。所有患者均获随访6～20个月，平均10.2个月。X线片显示骨折均愈合，愈合时间3.0～5.5个月，平均4.0个月。末次随访时，髋关节Harris评分82～97分，平均90.4分。其中优14例，良9例。随访期间未发生髋内翻、头髓钉切割、拔钉或断钉等并发症。
新型骨钩联合手指引导技术治疗老年难复性股骨粗隆间骨折可获得高质量的骨折复位及固定，疗效良好。
