[1]刘鹏宇,黄晖,肖军,等.股骨近端仿生髓内钉在老年骨质疏松性股骨粗隆间骨折治疗中的临床疗效[J].中国中医骨伤科杂志,2023,31(10):40-44.[doi:10.20085/j.cnki.issn1005-0205.231008]
　LIU Pengyu,HUANG Hui,XIAO Jun,et al.Clinical Study of Proximal Femoral Biomimetic Intramedullary Nail on the Treatment of Femoral Intertrochanteric Fracture Complicated with Osteoporosis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(10):40-44.[doi:10.20085/j.cnki.issn1005-0205.231008]
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股骨近端仿生髓内钉在老年骨质疏松性股骨粗隆间骨折治疗中的临床疗效()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年10期
页码:
40-44
栏目:
临床论著
出版日期:
2023-10-15

文章信息/Info

Title:
Clinical Study of Proximal Femoral Biomimetic Intramedullary Nail on the Treatment of Femoral Intertrochanteric Fracture Complicated with Osteoporosis
文章编号:
1005-0205(2023)10-0040-05
作者:
刘鹏宇1; 黄晖1; 肖军1; 彭风平1; 叶俊刚1; 张雷1; 付纳新1△
1国药葛洲坝中心医院骨科(湖北 宜昌,443000)
Author(s):
LIU Pengyu1; HUANG Hui1; XIAO Jun1; PENG Fengping1; YE Jungang1; ZHANG Lei1; FU Naxin1△
1Department of Orthopaedics,Guoyao Gezhouba Central Hospital,Yichang 443000,Hubei China.
关键词:
股骨近端仿生髓内钉;  股骨近端防旋髓内钉;  内固定;  股骨粗隆间骨折;  骨质疏松;  老年患者
Keywords:
proximal femoral biomimetic intramedullary nail;  proximal femoral antirotation intramedullary nail;  internal fixation;  intertrochanteric fracture of femur;  osteoporosis;  elderly patients
分类号:
R683.42
DOI:
10.20085/j.cnki.issn1005-0205.231008
文献标志码:
A
摘要:
目的:探讨股骨近端仿生髓内钉(PFBN)与股骨近端防旋髓内钉(PFNA)内固定治疗老年骨质疏松性股骨粗隆间骨折的临床疗效,为临床手术术式选择提供参考。方法:选择2021 年6月至 2022年6月收治的72例老年骨质疏松性股骨粗隆间骨折患者作为观察对象,根据手术方法分为股骨近端防旋髓内钉组(37例)和股骨近端仿生髓内钉组(35例)。观察两组患者的切口大小、出血量、手术时间、透视次数、术后至下地活动时间、住院时间、骨折愈合时间及术后至完全负重时间,对两组患者的骨折复位质量进行评价,统计两组患者术后1个月、3个月、6个月的Harris评分,两组患者术后并发症发生率及再次手术率。结果:股骨近端仿生髓内钉组的术后至下地活动时间、术后至完全负重时间及骨折愈合时间均比股骨近端防旋髓内钉组短,差异有统计学意义(P<0.05); 骨折复位质量评价明显优于股骨近端防旋髓内钉组,差异有统计学意义(P<0.05); 术后1个月、3个月及6个月的Harris评分均比股骨近端防旋髓内钉组高,差异有统计学意义(P<0.05); 术后并发症的总发生率比股骨近端防旋髓内钉组低,差异有统计学意义(P<0.05)。结论:股骨近端仿生髓内钉可为老年骨质疏松性股骨粗隆间骨折患者提供坚固的内固定,具有良好的骨折复位质量,缩短患者术后至下地活动的时间间隔、术后至完全负重的时间间隔及骨折愈合时间,降低术后并发症的总发生率,明显改善患者的Harris评分,在骨科领域的应用前景非常有潜力。
Abstract:
Objective:To compare the clinical efficacy of proximal femoral biomimetic intramedullary nail(PFBN)and proximal femoral nail intramedullary antirotation(PFNA)on the treatment of femoral intertrochanteric fracture complicated with osteoporosis,so as to provide reference for clinical operation.Methods:72 patients with femoral intertrochanteric fracture from June 2021 to June 2022 were divided into PFNA group(37 cases)and PFBN group(35 cases).The incision size,blood loss,operation time,fluoroscopy times,ground movement time,hospital stay,fracture healing time and complete weight bearing time were observed in the two groups.The quality of fracture reduction in the two groups was evaluated.The Harris scores of the two groups were observed at 1 month,3 months and 6 months after operation,and the incidence of postoperative complications and the rate of reoperation were observed in the two groups.Results:The time of underground movement,complete weight bearing and fracture healing in the PFBN group were shorter than those in the PFNA group,the quality of fracture reduction was significantly better than that in the PFNA group,the Harris score at 1 month,3 months and 6 months after operation was higher than that in the PFNA group,and the total incidence of postoperative complications in the PFNA group was lower than that in the PFNA group(P<0.05).Conclusion:PFBN can provide strong internal fixation for patients with intertrochanteric fracture complicated with osteoporosis,has a good evaluation of fracture reduction quality,effectively shorten the time of ground movement,complete weight-bearing time and fracture healing time,reduce the total incidence of postoperative complications,and significantly improve the Harris score of patients.It has a very potential application prospect in the field of orthopaedics in China.

参考文献/References:

[1] 侯志华.股骨近端防旋髓内钉内固定术与胫骨结节牵引术治疗老年股骨粗隆间骨折效果对比[J].中国药物与临床,2020,20(21):3624-3625.
[2] HARPER K D,NAVO P,RAMSEY F,et al.“Hidden” preoperative blood loss with extracapsular versus intracapsular hip fractures:what is the difference?[J].Geriatr Orthop Surg Rehabil,2017,8(4):202-207.
[3] 蒿俊行,董金辉,甄红军,等.股骨粗隆间骨折内侧皮质复位状态对骨折预后的影响[J].中国中医骨伤科杂志,2022,30(6):21-24.
[4] 周钰卓,齐宇新,马腾洋,等.老年股骨粗隆间骨折PFNA失败的危险因素分析[J].中国矫形外科杂志,2020,28(4):292-296.
[5] 中国脆性骨折联盟,中国老年医学学会骨与关节分会创伤骨科学术工作委员会,白求恩·骨科加速康复联盟,等.老年股骨转子间骨折诊疗指南[J].中华创伤骨科杂志,2020,22(2):93-99.
[6] KIM Y,DHEEP K,LEE J,et al.Hook leverage technique for reduction of intertrochanteric fracture[J].Injury,2014,45(6):1006-1010.
[7] CHANG S M,HOU Z Y,HU S J,et al.Intertrochanteric femur fracture treatment in Asia:what we know and what the world can learn[J].Orthop Clin North Am,2020,51(2):189-205.
[8] BHANDARI M,SWIONTKOWSKI M.Management of acute hip fracture[J].N Engl J Med,2017,377(21):2053-2062.
[9] MAGAZINER J,CHILES N,ORWIG D.Recovery after hip fracture:interventions and their timing to address deficits and desired outcomes-evidence from the baltimore hip studies[J].Nestle Nutr Inst Workshop Ser,2015,83:71-81.
[10] 门蒙,杨人军,李连铭,等.早期、晚期手术时机对老年髋部骨折患者疗效及近远期生活质量对比[J].中国老年学杂志,2021,41(19):4254-4256.
[11] TU D P,LIU Z,YU Y K,et al.Internal fixation versus hemiarthroplasty in the treatment of unstable intertrochanteric fractures in the elderly:a systematic review and meta-analysis[J].Orthop Surg,2020,12(4):1053-1064.
[12] LIU P,JIN D,ZHANG C,et al.Revision surgery due to failed internal fixation of intertrochanteric femoral fracture:current state-of-the-art[J].BMC Musculoskelet Disord,2020,21(1):573.
[13] MIN B W,LEE K J,OH J K,et al.The treatment strategies for failed fixation of intertrochanteric fractures[J].Injury,2019,50(7):1339-1346.
[14] 刘俊,谢华,赵银必,等.PFNA置入位点设计对股骨粗隆间骨折患者疗效及安全性的影响[J].创伤外科杂志,2021,23(1):28-32.
[15] 万家兴,王凯利,宋雪,等.股骨粗隆间骨折行股骨近端防旋髓内钉内固定术后失败的原因分析及手术经验总结[J].四川医学,2018,39(4):449-452.

备注/Memo

备注/Memo:
△通信作者 E-mail:470206003@qq.com
更新日期/Last Update: 2023-10-01