非牵引床手法复位PFNA内固定治疗股骨粗隆间骨折临床疗效分析

目的比较非牵引床手法复位股骨近端防旋髓内钉(PFNA)内固定与牵引床复位PFNA内固定治疗股骨粗隆间骨折的临床疗效。方法笔者自2014-12—2016-02采用非牵引床手法复位(非牵引床组)与牵引床复位(牵引床组)PFNA内固定治疗102例股骨粗隆间骨折。观察2组手术时间、透视时间、术中出血量、术后出血量。术后1、3、6及12个月对患者进行随访,观察骨折固定、愈合及并发症发生情况,采用疼痛视觉模拟评分(VAS)及髋关节功能Harris评分对术后功能进行评定。结果 91例获得随访平均12.8(12~14.3)个月。2组手术时间、透视时间、术中出血量、术后出血量比较差异均无统计学意义(P0.05)。非牵引床组手术时间较牵引床组缩短约10 min,有一定的临床现实意义。2组术后1、3、6及12个月VAS评分及髋关节功能Harris评分差异无统计学意义(P0.05)。结论非牵引床手法复位PFNA内固定治疗股骨粗隆间骨折取得满意的临床疗效,缩短了手术时间,值得临床推广。

Clinical curative effects evaluation of non-traction table with manual reduction using proximal femoral nail anti-rotation for femur intertrochanteric fractures

Objective To compare the clinical curative effects of non-traction table with manual reduction combined with proximal femoral nail anti-rotation (PFNA) and traction table reduction with PFNA for femur intertrochanteric fractures.Methods From December 2014 to February 2016,a total of 102 patients with intertrochanteric fractures who were treated with non-traction table with manual reduction(non-traction table group) or traction table reduction(traction table group) using proximal femoral nail anti-rotation were included into this retrospective study.The surgical time,fluoroscopy usage time,intraoperative blood loss amounts and postoperative blood loss amounts were recorded and compared between two groups.Follows-up were done at 1,3,6,and 12 months after survey.Fixing of fractures,bony healing and complications were observed.The visual analogue scale (VAS) and Harris hip score was employed to assess postoperative functional outcomes.Results Ninety one patients received effective follows-up with the average of 12.8 months (12-14.3 months).There were no significant differences in the surgical time,fluoroscopy usage time,intra-and post-operative blood loss amounts between two groups (P ＞0.05),but the operation time of non-traction table group was shortened by about 10 min,with the certain clinical significance.There were no statistically significant differences in VAS score and Harris hip score 1,3,6 and 12 months after surgery(P ＞0.05).Conclusion The clinical efficacy of non-traction table technique on the treatment of femur intertrochanteric fracture was satisfactory,and the operation time is shortened,which is worthy of clinical promotion.