[1]王瑞雄,吴天然,陈夏平,等.经皮钢丝环扎结合逆行髓内钉治疗股骨远端骨折26例[J].中国中医骨伤科杂志,2022,30(12):41-44.
　WANG Ruixiong,WU Tianran,CHEN Xiaping,et al.Functional Outcome of Percutaneous Wire Cerclage Plus Retrograde Intramedullary Nailing for Distal Femoral Fractures 26 Cases[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(12):41-44.
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经皮钢丝环扎结合逆行髓内钉治疗股骨远端骨折26例()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年12期
页码:
41-44
栏目:
临床报道
出版日期:
2022-12-15

文章信息/Info

Title:
Functional Outcome of Percutaneous Wire Cerclage Plus Retrograde Intramedullary Nailing for Distal Femoral Fractures 26 Cases
文章编号:
1005-0205(2022)12-0041-04
作者:
王瑞雄1; 吴天然1; 陈夏平1; 叶志强1; 敖庆芳1
1福建泉州市正骨医院(福建 泉州,362000)
Author(s):
WANG Ruixiong1; WU Tianran1; CHEN Xiaping1; YE Zhiqiang1; AO Qingfang1
1Quanzhou Osteopathy Hospital, Quanzhou 362000, Fujian China.
关键词:
股骨骨折;  逆行髓内钉;  钢丝环扎
Keywords:
femoral fractures;  retrograde intramedullary nailing;  wire cerclage
分类号:
R683.42
文献标志码:
B
摘要:
目的:探讨经皮钢丝环扎结合逆行髓内钉治疗股骨远端骨折的安全性和临床疗效。方法:回顾性分析2018年10月至2021年3月采用经皮钢丝环扎结合逆行髓内钉治疗的26例股骨远端骨折患者。男10例,女16例; 年龄为30～89岁,平均年龄为64岁; 左侧12例,右侧14例。按AO/OTA骨折分类法分类:A1.2型7例,A2.1型10例,A2.2型3例,A2.3型6例。受伤原因:交通事故伤5例,摔伤18例,坠落受伤3例。所有患者术中先透视下使用环形微创钢丝捆绑器经皮行骨折端钢丝环扎固定,再行股骨逆行髓内钉治疗。术后观察骨折愈合时间和术后并发症,随访过程中使用Schatzker-Lambert功能评分评估膝关节功能。结果:26例平均随访16个月(8～36个月),捆扎钢丝处切口长约3 cm。术中未发生血管神经损伤的病例,术后X 线片示骨折端对位对线良好。随访过程中未发现骨折不愈合和延迟愈合病例,且未发现感染病例。末次随访按股骨远端骨折Schatzker-Lambert功能评分:优15例,良9例,中2例,优良率为92%。结论:经皮钢丝环扎治疗股骨远端骨折操作简单、安全有效,能减少术中透视次数和手术时间,能维持骨折对位对线,并增强骨折端稳定性,且不影响骨折愈合。
Abstract:
Objective:To explore the safety and curative efficacy of percutaneous wire cerclage plus retrograde intramedullary nailing for distal femoral fractures.Methods:26 patients with distal femoral fractures from October 2018 to March 2021. 26 cases were retrospectively analyzed. All patients underwent for percutaneous wire cerclage combined with retrograde intramedullary nailing. There were 10 males and 16 females, aged 30 to 89 years old with 64 years old on average. There were 12 cases on the left side and 14 cases on the right side, according to AO/OTA classification, there were 7 cases of type A1.2, 10 cases of type A2.1, 3 cases of type A2.2 and 6 cases of type A2.3. Causes of injury: 5 cases of traffic accident, 18 cases of fall injury, falling injury in 3 cases. All patients were treated with percutaneous wire encircling fixation at the fracture end using a circular minimally invasive wire binder under fluoroscopy first, and then with femoral retrograde intramedullary nail treatment. Fracture healing time and postoperative complications were observed postoperatively. The Schatzker-Lambert function score was used to assess knee joint function during the follow-up.Results:The average follow-up period of the 26 cases was 16 months(8 to 36 months). The incision at the binding wire was about 3 cm long. In the case of no vascular and nerve injury during the operation, the postoperative X-ray showed that the fracture ends were reducted well. There were no cases of nonunion and delayed union of the fracture and no case of infection during the follow-up. According to the Schatzker-Lambert functional score of distal femoral fracture, there were 15 excellent cases, 9 good cases and 2 medium cases in the last follow-up, with the excellent and good rate of 92%.Conclusion:Percutaneous wire cerclage was safe, simple and effective on the treatment of distal femur fractures, which can reduce intraoperative fluoroscopy and surgical time, effectively maintain fracture alignment, and enhance the stability of fracture fixation, without affecting fracture healing.

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更新日期/Last Update: 2022-12-10