解放军医学杂志2017，Vol.42Issue(8)：712-716,5.DOI:10.11855/j.issn.0577-7402.2017.08.10
微创治疗老年不稳定股骨转子间骨折伴骨质疏松症的回顾性研究
Minimally invasive treatment of femoral intertrochanteric fracture in osteoporotic elderly patients:A retrospective study
摘要
Abstract
Objective To evaluate the clinical outcomes of minimally invasive internal fixation for femoral intertrochanteric fracture in osteoporotic elderly patients. Methods A retrospective study was conducted in 112 patients using interan nail (IN) or trochanteric antegrade nail (TAN) for the management of intertrochanteric femoral fracture from January 2009 to September 2015 in our hospital. According to AO classification, there were 34 cases of type 31-A.1, and 61 cases of type 31-A.2, 17 cases of type 31-A.3. Clinical and radiological follow-up were available. Surgical and fluoroscopic time, length of hospital stay, blood loss, complications and hip functions were compared between two groups. Results A total of 78 patients meeting the criteria were evaluated at a mean follow-up of 15 months (range, 3-27 months). The IN was used in 41 patients and the TAN in 37 patients. Operative time, fluoroscopy time and blood loss showed significant difference between the IN group and TAN group (respectively, 58.9±6.9 vs. 75.6±5.9min; 2.70±0.47 vs. 4.40±0.47min; 107.6±6.7 vs. 127.8±6.8ml, P<0.05), suggesting that patients treated with the IN experienced shorter operative and fluoroscopy times, less blood loss and better hip function (73%) than those with TAN (65%, P<0.05). Rate of postoperative complications was lower in the IN group (4.9%) than in the TAN group (10.8%, P<0.05). There was no difference in hospital stay and fracture healing time between the two groups (P>0.05). Conclusions For minimally invasive treatment of unstable femoral intertrochanteric fractures, use of either the IN or TAN is clinically effective. However, IN presents more advantages (e.g., easy operation, reliable fixation, less bleeding, better clinical outcomes, and less complications). The use of IN is a suitable option for the treatment of unstable intertrochanteric fractures in osteoporotic elderly patients.关键词
骨质疏松性骨折/股骨骨折/骨折固定术,髓内/外科手术,微创性Key words
osteoporotic fractures/femoral fractures/fracture fixation/intramedullary/surgical procedures/minimally invasive分类
医药卫生引用本文复制引用
辛龙,徐卫星,俞雷钧,王健,宋洪浦,钟甫华,刘亦杨,刘宏,张春..微创治疗老年不稳定股骨转子间骨折伴骨质疏松症的回顾性研究[J].解放军医学杂志,2017,42(8):712-716,5.基金项目
浙江省自然科学基金(LY13H060011)This work was supported by the Natural Science Foundation of Zhejing Province (LY13H060011) （LY13H060011）
