股骨转子间骨折PFNA内固定的体位选择初探

目的:探讨PFNA内固定治疗股骨转子间骨折使用不同体位的可行性及相关指标对比。方法:回顾性分析38例股骨转子间骨折在不同体位行PFNA内固定,分为2组,其中A组20例采用骨科牵引床,患者仰卧位。B组18例,患者侧卧位,不使用牵引床。结果:38例均获随访,时间5～18个月。在切口长度,手术难易程度,骨折复位程度,术中对助手的要求,术后髋关节功能评分等方面均有显著性差异,差异有统计学意义(P<0.05)。其中A组骨折复位程度明显优于B组,且对助手的要求低于B组[1],而B组在手术难易程度方面可降低手术困难,但对助手的要求较A组高,2者在手术时间,术中出血量,术中照片,摆体位的时间,骨折平均愈合时间方面没有显著性差异。结论:对EvansI型、II型及无明显移位的III型骨折可侧卧位,不使用牵引床手术。而对EvansIII型及IV型及V型骨折伴明显移位,并且复位较困难的骨折需采用骨科牵引床,患者仰卧位手术。

Femoral Fractures between Rotor PFNA Fixed Position Selection Trial

Objective:To study the PFNA internal fixation of femoral fracture between rotor using different position of feasibility and related index contrast.Methods:A retrospective analysis of 38 cases of femoral fracture between rotor in different position line PFNA internal fixation,divided into two groups,including A group of 20 patients with bone traction bed,patients supine position.B group of 18 cases,patients lateral position,do not use traction bed.Results:38 cases have been followed up,time 5～18 months.In the incision length,operation difficulty degree,the fracture degree,intraoperative to assistant requirements,postoperative hip function score were significant difference,the difference was statistically significant(P < 0.05).The fracture degree of group A was better than group B,and assistant to the requirement of less than group B(1),and group B in the operation difficulty degree can reduce the operation difficulty,but to the requirements of the assistant is A group of high,both in operation time,intraoperative blood loss,intraoperative photos,pendulum position time,fracture average healing time had no significant difference.Conclusion:The Evans type Ⅰ and type Ⅱ and type Ⅲ has no obvious shift of fractures could be lateral position,do not use traction bed operation.But to EvansIII type and type IV and V fracture with obvious shift,and reset more difficult fracture must be adopted to bone traction bed,the patient supine surgery.