精确定位防旋髓内钉置入治疗股骨转子间骨折

背景：闭合复位股骨近端防旋髓内钉内固定渐渐成为治疗股骨转子间骨折的金标准。 目的：通过与标准切口对比，评价精确定位法改良小切口使用股骨近端防旋髓内钉置入治疗股骨转子间骨折的优势。 方法：股骨转子间骨折接受闭合复位股骨近端防旋髓内钉置入内固定治疗的患者99例，其中采用改良后小切口方法的患者41例，采用标准切口的58例。对比两组患者的切口长度、内固定中出血量、平均住院时间及内固定后Harris评分。 结果与结论：采用改良切口组患者内固定中出血量较标准切口组少50.9%，切口长度短44%，平均置入内固定时间明显短于标准切口组（P〈0.05），两组患者平均住院时间及随访末期Harris评分值差异无显著性意义。说明使用股骨近端防旋髓内钉治疗股骨转子间骨折的病例，采用改良小切口具有切口更小，创伤更小，操作时间短及出血量少的优点。

Accurate positioning way to modify minimally invasive incision in the treatment of intertrochanteric fractures with proximal femoral nail antirotation

BACKGROUND：Closed reduction using proximal femoral nail antirotation gradual y becomes the golden standard in the treatment of intertrochanteric fractures. OBJECTIVE：To evaluate the advantages of proximal femoral nail antirotation in the treatment of intertrochanteric fractures by a new way that accurate positioning is used to modify the skin incision. METHODS：Ninety-nine patients with intertrochanteric fractures undergoing proximal femoral nail antirotation were included in the study, including 41 cases in the modified incision group and 58 cases in the standard operation group. Length of skin incision, mean bleeding volume, mean operation time, mean hospitalization time and the Harris scores were compared between two groups postoperatively. RESULTS AND CONCLUSION：Compared with the standard incision group, the mean bleeding volume and length of skin incision were decreased by 50.9%and 44%respectively in the modified incision group, as wel as the mean operation time was also shorter in the modified incision group （P〈0.05）. However, there was no difference in mean hospitalization time and Harris scores at the end of fol ow-up. The modified incision is more suitable for proximal femoral nail antirotation treatment of intertrochanteric fractures, with smal er incision, less trauma, shorter operation time and less blood loss.