[1]林晓毅△ 林凤晖 刘复安 杨俊.两种体位下PFNA治疗老年股骨粗隆间骨折的比较[J].中国中医骨伤科杂志,2017,25(06):33-36.
　LIN Xiaoyi LIN Fenghui LIU Fuan YANG Jun.Comparison of Two Postures in Treating the Elderly Femoral Intertrochanteric Fractures with PFNA[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(06):33-36.
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两种体位下PFNA治疗老年股骨粗隆间骨折的比较()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第25卷
期数:
2017年06期
页码:
33-36
栏目:
临床研究
出版日期:
2017-07-08

文章信息/Info

Title:
Comparison of Two Postures in Treating the Elderly Femoral Intertrochanteric Fractures with PFNA
文章编号:
1005-0205(2017)06-0033-04
作者:
林晓毅1△ 林凤晖2 刘复安1 杨俊1
1.厦门大学附属第一医院骨科(福建 厦门,361003)
2.厦门市思明区开元街道社区服务中心
△.通信作者 E-mail:51499082@qq.com
Author(s):
LIN Xiaoyi1△ LIN Fenghui2 LIU Fuan1 YANG Jun1
1.Department of Orthopedics,First Affiliated Hospital of Xiamen University,Xiamen 361003,Fujian China;
2.Community Service Center of Kaiyuan Street,Siming District,Xiamen 361003,Fujian China.
关键词:
侧卧位;  仰卧位;  股骨近端防旋髓内钉;  老年;  股骨粗隆间骨折
Keywords:
lateral decubitus position;  supine position;  proximal femoral nail antirotation;  elderly;  femoral intertrochanteric fracture
分类号:
R683.42
文献标志码:
A
摘要:
目的:比较侧卧位和仰卧位下选用股骨近端防旋髓内钉(Proximal Femoral Nail Antirotation,PFNA)治疗老年股骨粗隆间骨折的疗效。方法:回顾分析2010年1月至2014年1月收治的100例行股骨近端防旋髓内钉(PFNA)内固定治疗的老年股骨粗隆间骨折患者,分别采用侧卧位徒手牵引和仰卧位牵引床牵引,对两组患者体位摆放成功的时间、术中出血量、手术时间、术中透视次数及术后1年的Harris评分进行比较。结果:侧卧位组在患者体位摆放成功的时间、术中出血量、手术时间、术中透视次数比仰卧位组有优势,差异有统计学意义(P<0.05),而在术后1年髋关节功能评分方面两组比较差异无统计学意义(P>0.05)。结论:侧卧位行PFNA治疗老年股骨粗隆间骨折具有手术时间短、出血少、透视少、操作简单等优点。
Abstract:
Objective:To compare the therapeutic effect of two postures in treating the elderly femoral intertrochanteric fractures with proximal femoral nail antirotation(PFNA).Methods:From January 2010 to January 2014,100 elderly patients with intertrochanteric fractures were treated with PFNA,including 60 cases of manual traction in the lateral decubitus position and 40 cases of fracture-table traction in the supine position.The operative time,blood loss during operation,intraoperative fluoroscopy times and Harris score of postoperative l year were compared in our study.Results:The lateral position group had more advantage than the supine position group in operative time,the blood loss during the operation and the intraoperative fluoroscopy times(P<0.05),but had no advantage in Harris score of postoperative l year(P>0.05). Conclusion:Treating the elderly femoral intertrochanteric fractures with PFNA in lateral decubitus position is a new choice,with the advantages of shorter operative time,less blood loss and less fluoroscopy times.

参考文献/References:

[1] Weller I,Wai EK,Jaglal S,et al.The effect of hospital type and surgical delay on mortality after surgery for hip fracture[J].J Bone Joint Surg Br,2005,87(3):361-366.
[2] Callanan I,Choudhry V,Smith H.Perineal sloughing as a result of pressure necrosis from the traction post during prolonged bilateral femoral nailing[J].Injury,1994,25(7):472.
[3] Brumback RJ,Ellison TS,Molligan H,et al.Pudendal nerve palsy complicating intramedullary nailing of the femur[J].J Bone Joint Surg Am,1992,74(10):1450-1455.
[4] 林晓毅,袁华澄,游戊己.DHS、LPFP、PFN和PFNA治疗老年股骨粗隆间骨折的临床分析[J].中国骨与关节损伤杂志,2011,26(10):878-880.
[5] Leading the way to optimal stability:synthes,original instruments and implants of the Association for the Study of Internal Fixation[M].AO/ASIF.Oberdorf:Stratec Medical,2004:1-44.
[6] 刘巍,曹建明,李健飞.侧卧体位下近端髓内钉-螺旋刀片治疗股骨转子间骨折32例疗效观察[J].蚌埠医学院学报,2012,37(9):1097-1098.
[7] Connelly CL,Archdeacon MT.The lateral decubitus approach for complex proximal femur fractures:anatomic reduction and locking plate neutralization:a technical trick[J].J Orthop Trauma,2012,26(4):252-257.
[8] Bishop JA,Rodriguez EK.Closed intramedullary nailing of the femur in the lateral decubitus position[J].J Trauma,2010,68(1):231-235.
[9] 罗勤瑜,胡奕山,陈春雷,等.两种体位行PFNA治疗老年股骨粗隆间骨折的对比研究[J].中国矫形外科杂志,2012,20(20):681-684.
[10] Xue L,Zha L,Chen Q,et al.Randomized controlled trials of proximal femoral nail antirotation in lateral decubitus and supine position on treatment of intertrochanteric fractures[J].Scientific World Journal,2013:276015.
[11] 黄晋,吴漾,邱雪立.侧卧位和仰卧位PFNA治疗股骨粗隆骨折的比较[J].实用医学杂志,2011,27(21):3914-3916.
[12] 罗勤瑜,胡奕山,郭予立,等.侧卧位行股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的临床疗效分析[J].中国矫形外科杂志,2011,19(18):1572-1574.
[13] 陈学强,吴群峰,俞立新,等.无牵引架侧卧位 PFNA 内固定治疗股骨粗隆间骨折 50 例体会[J].中国骨与关节损伤杂志,2014,29(6):19-20.
[14] Carr JB,Williams D,Richards M.Lateral decubitus positioning for intramedullary nailing of the femur without the use of a fracture table[J].Orthopedics,2009,32(10):721-724.
[15] 杨博,史宝明,窦晓文,等.在侧卧位下行股骨粗隆间骨折固定手术的透视方法[J].中国煤炭工业医学杂志,2011,14(11):1644.
[16] 黄凤琪,肖小注,邓建龙,等.两种体位下PFNA治疗老年股骨粗隆间骨折的临床比较[J].实用骨科杂志,2015,21(5):448-450.

更新日期/Last Update: 2017-06-15