[1]李明 周立义 李君.加长型与标准型股骨近端防旋髓内钉治疗 不稳定性转子间骨折的比较[J].中国中医骨伤科杂志,2016,24(04):22-25.
　LI Ming ZHOU Liyi LI Jun.Comparison of Curative Effect of the Long Type and the Standard Type Proximal Femoral Nail Antirotation to Treat Unstable Intertrochanteric Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2016,24(04):22-25.
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加长型与标准型股骨近端防旋髓内钉治疗 不稳定性转子间骨折的比较
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第24卷
期数:
2016年04期
页码:
22-25
栏目:
临床研究
出版日期:
2016-04-15

文章信息/Info

Title:
Comparison of Curative Effect of the Long Type and the Standard Type Proximal Femoral Nail Antirotation to Treat Unstable Intertrochanteric Fracture
文章编号:
1005-0205(2016)04-0022-04
作者:
李明1 周立义1 李君1
1.海南医学院附属医院骨科(海口,570102)
Author(s):
LI Ming1 ZHOU Liyi1 LI Jun1
1.The Affiliated Hospital of Hainan Medical University,HaiKou,570100,Hainan,China.
关键词:
加长型PFNA;  标准型PFNA;  不稳定转子间骨折;  股骨
Keywords:
the long type PFNA;  the standard type PFNA;  unstable intertrochanteric fracture;  femur
分类号:
R683.42
文献标志码:
A
摘要:
目的:分析比较加长型与标准型股骨近端防旋髓内钉(PFNA)治疗不稳定性转子间骨折的临床效果。方法:收集2009年5月至2014年5月采用加长型与标准型股骨近端防旋髓内钉治疗且获得随访的120例不稳定性转子间骨折患者的临床资料,将病例分为标准型PFNA组(S组)、加长型PFNA组(L组),记录两组患者手术时间、术中出血、住院时间及两组患者Harris评分及功能恢复情况; 对骨折愈合情况、影像学情况、并发症的情况进行评估。结果:两组患者手术时间、术中出血、住院时间、骨折平均愈合时间、Harris评分差异均无统计学意义(P>0.05)。S组螺旋刀片移位、股骨远端继发性骨折的发生率明显高于L组,差异有统计学意义(P<0.05)。L组患者在总并发症率、再手术率上均优于S组患者,差异有统计学意义(P<0.05),两组患者死亡率差异无统计学意义(P>0.05)。结论:对于高龄不稳定转子间骨折的患者,加长型PFNA具有固定牢固、术后并发症少、生物力学性能好等优点,值得临床推广。
Abstract:
Objective:To explore and compare curative effect of the long type and the standard type proximal femoral nail antirotation to treat unstable intertrochanteric fracture.Methods:120 cases of unstable intertrochanteric fracture was collected in May 2009 to May 2014 in our hospital.They were treated with the the long type and the standard type PFNA and obtained more than a year of follow-up.They were divided into two groups: the long type PFNA group(group L)and the standard type PFNA group(group S).The operation time,intraoperative mean bleeding volum,the length of time,fracture union and situation of imaging,clinical complications,Harris score and functional recovery of two group were recorded and evaluated.Results:For the operation time,intraoperative bleeding,average hospitalization time,fracture healing time,Harris score of two groups,the differences had no statistical significance(P>0.05).The incidence of spiral blade displacement and the secondary distal femur fractures in group S are significantly higher than that in group L.The difference was statistically significant(P<0.05).The total complication rate and reoperation rate of patients in group L were better than that in group S.The difference was statistically significant(P<0.05).The differences of the mortality between two groups have no statistical significance(P>0.05).Conclusion:For elderly patients with unstable intertrochanteric fracture,the long type PFNA has a lot of advantages such as more firm fixation,less postoperative complications,better biological mechanics performance.And it deserved the clinical promotion.

参考文献/References:

[1] 王国栋,袁同洲,许诺,等.防旋型股骨近端髓内钉治疗老年股骨转子间骨折[J].中国组织工程研究,2014,18(17):2679-2684.
[2] Schipper IB,Marti RK,van der Werken C.Unstable trochanteric femoral fractures:extramedullary or intramedullary fixation.Review of literature[J].Injury,2004,35(2):142-151.
[3] Chou DT,Taylor AM,Boulton C,et al.Reverse oblique intertrochanteric femoral fractures treated with the intramedullary hip screw(IMHS)[J].Injury,2012,43(6):817-821.
[4] Okcu G,Ozkayin N,Okta C,et al.Which implant is better for treating reverse obliquity fractures of the proximal Femur:a standard or long nail?[J].Clinical Orthopaedics and Related Research,2013(9):2768-2775.
[5] Boone C,Carlberg KN,Koueiter DM,et al.Short versus long intramedullary nails for treatment of intertrochanteric femur fractures(OTA 31-A1 and A2)[J].J Orthop Trauma,2014,28(5):96-100.
[6] Kitamura S,Hasegawa Y,Suzuki S,et al.Functional outcome after hip fracture in Japan[J].Clin Orthop Relat Res,1998,348:29-36.
[7] Ma KL,Wang X,Luan FJ,et al.Proximal femoral nails antirotation,Gamma nails,and dynamic hip screws for fixation of intertrochanteric fractures of femur:A meta-analysis[J].Orthop Traumatol Surg Res,2014,100(8):859-866.
[8] Sadic S,Custovic S,Jasarevic M,et al.Proximal femoral nail antirotation in treatment of fractures of proximal femur[J].Med Arch,2014,68(3):173-177.
[9] Brunner A,Jockel JA,Babst R.The PFNA proximal femur nail in treatment of unstable proximal femur fractures-3 cases of postoperative perforation of the helical blade into the hip joint[J].J Orthop Trauma,2008,22(10):731-736.
[10] Mereddy P,Kamath S,Ramakrishnan M,et al.The AO/ASIF proximal femoral nail antirotation(PFNA):a new design for the treatment of unstable proximal femoral fractures[J].Injury,2009,40(4):428-432.
[11] 陈光,朱勇,许会敏,等.加长Gamma钉内固定治疗老年不稳定股骨粗隆间骨折[J].中国矫形外科杂志,2002,10(12):1234-1236.
[12] 陈兴华,刘涛,黄珍谷.长、短股骨近端防旋髓内钉固定股骨转子间骨折的对比[J].中国组织工程研究,2014,18(4):595-600.
[13] Baumgaertner MR,Curtin SL,Lindskog DM.Intramedullary versus extramedullary fixation for the treatment of intertrochanteric hip fractures[J].Clin Orthop Relat Res,1998,348:87-94.
[14] 张绍安,李智浩,魏新军,等.加长型股骨近端防旋髓内钉治疗涉及转子间的股骨长段粉碎性骨折[J].中华创伤骨科杂志,2014,16(7):642-644.
[15] Barton TM,Robert G,Claire T,et al.A comparison of the long gamma nail with the sliding hip screw for the treatment of AO/OTA 31-A2 fractures of the proximal part of the femur:a prospective randomized trial.[J].Journal of Bone and Joint Surgery:American Volume,2010(4):792-810.
[16] Sears BR,Ostrum RF,Litsky AS.A mechanical study of gap motion in cadaveric femurs using short and long supracondylar nails[J].J Orthop Trauma,2004,18(6):354-360.

备注/Memo

备注/Memo:
收稿日期:2015-07-07
更新日期/Last Update: 2016-04-15