动力髋螺旋刀系统与螺旋刀片抗旋髓内钉修复不稳定型股骨转子间骨折比较

背景：股骨近端骨折后使用抗旋髓内钉髓内固定能够代替股骨轴承受重力的轴心，相对于髋螺钉和动力踝螺钉向身体轴侧移动，增强骨折部位的抗疲劳强度，能够支撑抗内翻及阻止近端骨折部位的旋转作用，适用于修复不稳定型骨折。 目的：对比观察动力髋螺旋刀系统与微创螺旋刀片抗旋髓内钉置入内固定修复不稳定型股骨转子间骨折的效果。 方法：选择2012年1月至2014年1月顺德第一人民医院骨科收治的82例不稳定型股骨转子间骨折患者为观察对象。根据随机数字表法分为两组，动力髋螺旋刀系统组与微创螺旋刀片抗旋髓内钉组各41例。比较两组患者的临床修复指标、骨折愈合时间与及并发症发生情况。 结果与结论：微创螺旋刀片抗旋髓内钉组的骨折愈合时间及临床修复指标均显著优于动力髋螺旋刀系统组，差异有显著性意义(P < 0.05)。微创螺旋刀片抗旋髓内钉组中有5例患者发生并发症，发生率为12%；动力髋螺旋刀系统组中有10例患者发生并发症，发生率为24%。微创螺旋刀片抗旋髓内钉组的并发症发生率显著低于动力髋螺旋刀系统组，差异有显著性意义(P < 0.05)。提示针对不稳定型股骨转子间骨折患者而言，选择微创螺旋刀片抗旋髓内钉置入内固定能够降低并发症发生率，提高修复的安全性，对患者的功能恢复具有促进作用。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Dynamic hip screw knife system versus spiral blade anti-rotation intramedullary nail in the treatment of unstable intertrochanteric fractures

BACKGROUND:Anti-rotation intramedullary nail fixation for proximal femoral fractures replaces the femoral bearing axis, moves towards body axis relative to hip screw and dynamic ankle screw, enhances the anti-fatigue strength at the fracture site, supports the anti-varus and prevents the rotation of the proximal fracture site, and is suitable for the treatment of unstable fracture. OBJECTIVE:To comparatively observe the effects of dynamic hip screw knife system and minimally invasive spiral blade anti-rotation intramedullary nail in the repair of unstable intertrochanteric fractures. METHODS:A total of 82 cases of unstable intertrochanteric fractures, who were treated in the Department of  Orthopedics, First People’s Hospital of Shunde from January 2012 to January 2014, were selected in this study. The patients were equally and randomly divided into two groups: dynamic hip screw knife system group and minimally invasive spiral blade anti-rotation intramedullary nail group. Repair index, fracture healing time and the incidence of complications were compared between the two groups. RESULTS AND CONCLUSION:Healing time and repair index were significantly better in the minimally invasive spiral blade anti-rotation intramedullary nail group than in the dynamic hip screw knife system group (P < 0.05). Complications appeared in five patients from the minimally invasive spiral blade anti-rotation intramedullary nail group, with the incidence rate of 12%, and in ten patients from the dynamic hip screw knife system group, with the incidence rate of 24%. The incidence of complications was significantly lower in the minimally invasive spiral blade anti-rotation intramedullary nail group than in the dynamic hip screw knife system group (P < 0.05). These data suggest that for patients with unstable intertrochanteric fracture, minimally invasive spiral blade anti-rotation intramedullary nail can decrease the incidence of complications, elevate the safety of the repair method, and promote the functional recovery.