弯钳撬拔术在PFNA内固定治疗难复性股骨粗隆间骨折中的应用OA
Application of Bending Forceps Prying and Pulling Technique in the Treatment of Refractory Intertrochanteric Fracture of Femur with PFNA Internal Fixation
目的:探讨弯钳撬拔术在股骨近端髓内钉(proximal femoral nail antirotation,PFNA)内固定治疗难复性股骨粗隆间骨折中的应用效果.方法:选择 2021 年 6 月—2023 年 5 月在罗定市中医院接受手术治疗的难复性股骨粗隆间骨折患者 144 例,用随机数字表法将患者分为对照组(n=72,接受切开复位PFNA内固定治疗)、观察组(n=72,接受弯钳撬拔PFNA内固定治疗).对比两组手术基本情况、骨折愈合情况、髋关节功能评分、并发症发生情况.结果:两组手术时间比较,差异无统计学意义(P>0.05);观察组术中出血量较对照组少,差异有统计学意义(P<0.05).观察组术后住院时间、负重开始时间、骨折愈合时间均较对照组短,差异均有统计学意义(P<0.05).术后 6 个月,观察组髋关节功能评分较对照组高,差异有统计学意义(P<0.05).两组术后 6 个月的髋关节功能优良率比较,差异无统计学意义(P>0.05).两组并发症发生率比较,差异无统计学意义(P>0.05).结论:弯钳撬拔PFNA内固定治疗难复性股骨粗隆间骨折较切开复位PFNA内固定治疗更具优势,在促进术后骨折愈合、恢复患侧髋关节功能方面的作用均较理想,且不会增加并发症,是一种优质的手术模式.
Objective:To investigate the application effect of bending forceps prying and pulling technique in the treatment of refractory intertrochanteric fracture of femur with proximal femoral nail antirotation(PFNA)internal fixation.Method:A total of 144 patients with refractory intertrochanteric fracture of femur who received surgical treatment in Luoding Hospital of Traditional Chinese Medicine from June 2021 to May 2023 were selected and divided into control group(n=72,treated with open reduction and PFNA internal fixation)and observation group(n=72,treated with bending forceps prying and pulling technique and PFNA internal fixation)by random number table method.The basic conditions of operation,fracture healing,hip function score and complications were compared between the two groups.Result:There was no significant difference in operation time between the two groups(P>0.05).The intraoperative bleeding volume in the observation group was less than that in the control group,the difference was statistically significant(P<0.05).Postoperative hospital stay,weight loading start time and fracture healing time in observation group were shorter than those in control group,the differences were statistically significant(P<0.05).6 months after operation,the hip function score of observation group was higher than that of control group,the difference was statistically significant(P<0.05).There was no significant difference in the rate of excenent and good hip function 6 months after operation between two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Compared with open reduction and PFNA internal fixation in the treatment of refractory intertrochanteric fracture of femur,bending forceps prying and pulling technique and PFNA internal fixation has more advantageous,and it has a better role in promoting postoperative fracture healing and restoring the function of the affected hip joint,and it does not increase complications,which is a high-quality surgical mode.
刘建卫;刘远文;李彬;李金郑
罗定市中医院骨一科 广东 罗定 527200
难复性股骨粗隆间骨折弯钳撬拔术股骨近端髓内钉骨折愈合髋关节功能
Refractory intertrochanteric fracture of femurBending forceps prying and pulling techniquePFNAFracture healingHip function
《中国医学创新》 2024 (020)
18-22 / 5
广东省中医药局科研项目(20231421)
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