[1]任东坡,倘艳锋.股骨近端防旋髓内钉内固定治疗不稳定型股骨转子间骨折[J].中医正骨,2016,28(07):61-63.
点击复制

股骨近端防旋髓内钉内固定治疗不稳定型股骨转子间骨折()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年07期
页码:
61-63
栏目:
临床报道
出版日期:
2016-07-20

文章信息/Info

作者:
任东坡; 倘艳锋
1.河南省新密市中医院,河南 新密 452370; 2.河南省洛阳正骨医院/河南省骨科医院,河南 洛阳 471002
关键词:
髋骨折;  骨折固定术; 髓内
摘要:
目的:探讨股骨近端防旋髄内钉内固定治疗不稳定型股骨转子间骨折的临床疗效和安全性。方法:2011年1月至2013年12月,采用股骨近端防旋髓内钉内固定治疗不稳定型股骨转子间骨折患者45例,男26例、女19例; 年龄22～83岁,中位数63岁; 左侧26例,右侧18例,双侧1例。骨折Evans分型,Ⅰc型26例、Ⅰd型17例、Ⅱ型2例。记录手术时间、术中出血量,并随访观察骨折愈合、髋关节功能恢复及并发症发生情况。结果:本组手术时间40～100 min,中位数75 min; 术中出血量150～300 mL,中位数240 mL。45例患者均获随访,随访时间12～20个月,中位数14个月; 骨折愈合44例,愈合时间14～22周,中位数18周。术后12个月采用Harris髋关节评分标准评价疗效,本组Harris评分(89.35±6.83)分,优37例、良4例、可2例、差2例。并发下肢深静脉血栓形成和肺栓塞1例,经溶栓及抗凝等治疗后好转; 并发骨折不愈合1例,术后8个月取出髓内钉后改行髂骨植骨股骨近段锁定钢板内固定,骨折愈合; 并发髋内翻2例,未行特殊处理。无股骨头坏死、髋臼损伤等并发症发生。结论:股骨近端防旋髓内钉内固定治疗不稳定型股骨转子间骨折,损伤小、出血少,术后可早期功能锻炼,有利于骨折愈合和髋关节功能恢复,安全可靠。

参考文献/References:

[1] Canale ST,Besty JH.坎贝尔骨科手术学[M].11版.北京:人民军医出版社,2009:2005-2555. [2] 尹乾兵,殷勇.PFNA治疗股骨粗隆间骨折失效的原因浅析[J].实用骨科杂志,2015,21(5):456-459. [3] 刘云鹏,刘沂.骨与关节损伤和疾病的诊断分类及功能评定标准[M].北京:清华大学出版社,2002:71-72. [4] 祝军峰,徐农,金盛.股骨近端防旋髓内钉治疗内固定治疗老年不稳定型股骨转子间骨折[J].临床骨科杂志,2015,18(4):455-456. [5] Harris WH.Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty. An end-result study using a new method of result evaluation[J].J Bone Joint Surg Am,1969,51(4):737-755. [6] Van Ness PH,Peduzzi PN,Quagliarello VJ.Efficacy and effectiveness as aspects of cluster randomized trials with nursing home residents:Methodological insights from a pneumonia prevention trial[J].Contemp Clin Trials,2012,33(6):1124-1131. [7] 王宗仁,刘长贵,王宝军,等.股骨近端带锁髓内钉在粗隆间骨折的应用[J].中华创伤骨科杂志,2002,4(3):195-198. [8] 孙群周,阮成群,李光明,等.股骨近端防旋髓内钉内固定治疗老年不稳定型股骨转子间骨折[J].中医正骨,2015,27(10):20-21. [9] Han N,Sun GX,Li ZC,et al.Comparison of proximal femoral nail antirotation blade and reverse less invasive stabilization system-distal femur systems in the treatment of proximal femoral fractures[J].Orthop Surg,2011,3(1):7-13. [10] 郑艳峰,吴勋,周荣昌,等.股骨近端防旋髓内钉内固定与动力髋螺钉内固定治疗老年股骨转子间骨折的对比研究[J].中医正骨,2015,27(4):24-28. [11] Shao CP,Wang BY,Ye SH,et al.DEL RBC transfusion should be avoided in particular blood recipient in East Asia due to allosensitization and ineffectiveness[J].J Zhejiang Univ Sci B,2012,13(11):913-918. [12] Magnus MW.Vestrheim DF,Nystad W,et al.Decline in Early Childhood Respiratory Tract Infections in the Norwegian Mother and Child Cohort Study after Introduction of Pneumococcal Conjugate Vaccination[J].Pediatr Infect Dis J,2012,31(9):951-955. [13] Zhang P,Li C,Li Y,et al.Proteomic identification of differentially expressed proteins in sea cucumber Apostichopus japonicus coelomocytes after Vibrio splendidus infection[J].Dev Comp Immunol,2014,44(2):370-377. [14] Laulund AS,Lauritzen JB,Duus BR,et al.Routine blood tests as predictors of mortality in hip fracture patients[J].Injury,2012,43(7):1014-1020. [15] 张昌猛,孙天胜,任继鑫,等.亚洲型股骨近端防旋髓内钉与InterTan系统治疗老年股骨转子间骨折的对比研究[J].中医正骨,2013,25(7):20-23. [16] 任磊,孙永青,郝敬东.术中尖顶距控制在PFNA内固定治疗中的应用研究[J].实用骨科杂志,2012,18(10):887-889. [17] Baumgaertner MR,Curtin SL,Lindskog DM,et al.The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip [J].J Bone Joint Surg Am,1995,77(7):1058-1064.

相似文献/References:

[1]温超海,何忠,李永斌,等.闭合复位伽玛钉改良成锁定支架内固定治疗 老年股骨转子间骨折[J].中医正骨,2015,27(11):32.
[2]肖善富,张喜善,于凤珍.髌下小切口钢丝纽扣式内固定治疗胫骨髁间隆突骨折[J].中医正骨,2015,27(11):34.
[3]朱峰,宋相建,吴蔚,等.手法复位经皮克氏针内固定治疗 儿童闭合性肱骨远端全骨骺分离[J].中医正骨,2015,27(11):51.
[4]裘人华,胡培阳,裘天强,等.闭合复位外固定架固定治疗Colles骨折[J].中医正骨,2015,27(11):59.
[5]葛波涌,王玉波,王明太,等.交锁髓内钉内固定治疗胫骨干骨折的临床研究[J].中医正骨,2015,27(10):8.
　GE Boyong,WANG Yubo,WANG Mingtai,et al.Clinical study on the internal fixation with interlocking intramedullary nail for the treatment of tibial shaft fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):8.
[6]孙群周,阮成群,李光明,等.股骨近端防旋髓内钉内固定治疗 老年不稳定型股骨转子间骨折[J].中医正骨,2015,27(10):20.
[7]方策,倪新宇,王宏伟,等.迟氏正骨手法复位单臂外固定支架固定治疗 老年股骨转子间骨折[J].中医正骨,2015,27(10):22.
[8]全先辉,万春友,刘磊,等.Taylor空间支架外固定治疗胫腓骨开放性骨折[J].中医正骨,2015,27(10):30.
[9]茆军,张惠法,严培军,等.Ilizarov外固定支架结合克氏针固定治疗Pilon骨折[J].中医正骨,2015,27(10):32.
[10]袁伟,周晓莉.T形掌指骨微型钢板内固定治疗锁骨近端骨折[J].中医正骨,2015,27(10):47.
[11]邓红敏,刘志诚.转子间斜行截骨结合股骨近端防旋髓内钉固定治疗 股骨近端骨折术后髋内翻畸形[J].中医正骨,2015,27(10):17.
[12]朱云森,江敞,李俊.氨甲环酸对老年股骨转子间骨折髓内固定术 围手术期隐性失血的影响[J].中医正骨,2015,27(06):16.
　ZHU Yunsen,JIANG Chang,LI Jun.Effect of tranexamic acid on perioperative hidden blood loss in aged patients receiving intramedullary fixation for treatment of intertrochanteric fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):16.
[13]吴鹏,王博,孔令成,等.强骨饮颗粒联合阿仑膦酸钠维D3片口服在原发性骨质疏松性髋部骨折术后抗骨质疏松治疗中的应用[J].中医正骨,2016,28(05):16.
　WU Peng,WANG Bo,KONG Lingcheng,et al.Oral application of Qiangguyin Keli(强骨饮颗粒)and alendronate sodium Vitamin D3 tablets in postoperative anti-osteoporosis treatment in patients with primary osteoporotic hip fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(07):16.
[14]陈勍,刘钟,陈文亮,等.股骨近端防旋髓内钉固定联合口服仙灵骨葆胶囊治疗肾阳虚型骨质疏松性股骨转子间骨折[J].中医正骨,2017,29(07):69.
[15]董根荣,陈龙,何斌,等.加味桃红四物汤对老年股骨转子间骨折股骨近端防旋髓内钉内固定术围手术期隐性失血的影响[J].中医正骨,2017,29(09):12.
　DONG Genrong,CHEN Long,HE Bin,et al.Influence of Jiawei Taohong Siwu Tang(加味桃红四物汤)on perioperative hidden blood loss in aged patients who received proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(07):12.

备注/Memo

备注/Memo:
2016-05-14收稿 2016-06-05修回

更新日期/Last Update: 1900-01-01