螺旋刀片不同位置对股骨近端防旋髓内钉治疗老年股骨转子间骨折效果的影响
Influence of different spiral blade position on the effect of proximal femoral nail anti-rotation for femoral intertrochanteric fractures in the elderly
毕红宾 1李岩 1杨亚丽 1邢庆胜1
作者信息
- 1. 河南省洛阳正骨医院(河南省骨科医院)骨科,河南 郑州 450008
- 折叠
摘要
目的 探讨螺旋刀片不同位置对股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折效果的影响.方法 将100 例老年股骨转子间骨折患者按照螺旋刀片位置不同分为A组(螺旋刀片放置在股骨头颈中部行PFNA治疗,50 例)和B组(螺旋刀片放置在股骨头颈中下1/3 部行PFNA治疗,50 例).比较两组术后骨折复位质量、尖顶距(TAD)、螺旋刀片钉尾突出长度、骨折愈合时间、开始部分负重行走时间、术后并发症发生情况.采用髋关节Harris评分评价临床疗效.结果 患者均获得随访,时间6～24 个月.术后骨折复位质量优良率、TAD、骨折愈合时间、开始部分负重行走时间、术后并发症发生率、术后各时间点髋关节Harris评分两组比较差异均无统计学意义(P＞0.05);螺旋刀片钉尾突出长度A组大于B组(P＜0.01).结论 行PF-NA治疗老年股骨转子间骨折时,螺旋刀片无论放置在股骨头颈中部或中下1/3 部,只要能够实现坚强固定,其临床疗效无差异.
Abstract
Objective To investigate the infulence of spiral blade position on the curative effect of proximal femoral nail anti-rotation(PFNA)for treatment of elderly intertrochanteric fractures.Methods The 100 elderly patients with elderly intertrochanteric fractures were divided into group A(50 cases were treated by PFNA with spiral blades placed in the middle of the femoral head-neck)and group B(50 cases were treated by PFNA with spiral blades placed in the middle and lower one-third of the femoral head-neck),according to different positions of spiral blades.The quality of fracture reduction,top apex distance(TAD),spiral blade nail tail protruding length,fracture healing time,start time of partial weight-bearing walking and postoperative complications were compared between the two groups.The clinical effect was evaluated by hip Harris score.Results All patients in both groups were followed up for 6～24 months.There were no statistical differences in the quality of fracture reduction,TAD,fracture healing time,start time of partial weight-bearing walking,incidence of postoperative complications and Harris score of hip joint at various time-point be-tween the two groups(P＞0.05).Group A was longer than group B in the protruding length of spiral blade nail tail(P＜0.01).Conclusions During PFNA for treatment of elderly femoral intertrochanteric fractures,whether the spi-ral blade is placed in the middle of the femoral head and neck or the middle and lower 1/3,as long as firm fixation can be achieved,there is no difference in clinical efficacy.
关键词
股骨转子间骨折/股骨近端防旋髓内钉/螺旋刀片/位置/老年人Key words
femoral intertrochanteric fractures/proximal femoral nail anti-rotation/spiral blade/position/aged引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据