摘要
Abstract
Objective To compare the therapeutic effects of closed reduction intramedullary nail fixation and open re-duction intramedullary nail plus plate internal fixation and bone grafting on the femoral subtrochanteric Seinsheimer type-Ⅴ fracture.Methods The 60 patients with femoral subtrochanteric Seinsheimer type-Ⅴ fractures were divided into the closed group(treated with closed reduction intramedullary nail fixation,34 cases)and the open group(trea-ted with open reduction intramedullary nail plus plate internal fixation and bone grafting,26 cases),according to dif-ferent surgical procedures.The intraoperative bleeding volume,surgical time,postoperative hospital stay,fracture heal-ing time,incidence of complications,pain VAS,and hip flexion range of motion between two groups were compared.Harris scores were used to evaluate efficacy.Results Three cases were lost to follow-up(there were 2 cases in the closed group and 1 case in the open group),while the remaining 57 cases were followed up for 12 months.The volume of intraoperative bleeding,surgical time,and postoperative hospital stay in the closed group were all lower(shorter)than those in the open group(P＜0.05).The incidence of complications in the closed group was lower than that in the open group(P＜0.05).Excluding 3 cases of lost follow-up and 3 cases of delayed fracture healing(2 cases in the closed group and 1 case in the open group),the fracture healing time in the open group was shorter than that in the closed group(P＜0.05).At the last follow-up,there was no statistical difference in pain VAS between the two groups(P＞0.05);Harris score and hip flexion range of motion were higher(larger)in the open group than those in the closed group(P＜0.05).Conclusions Treatment of femoral subtrochanteric Seinsheimer type-Ⅴ fracture,closed re-duction and intramedullary nail fixation have advantages in terms of intraoperative safety,incidence of complications and postoperative recovery time;open reduction with intramedullary nails plus plate internal fixation and bone grafting have advantages in improving fracture healing time and hip joint function.关键词
股骨转子下骨折/Seinsheimer Ⅴ型/闭合复位髓内钉固定术/切开复位髓内钉固定术Key words
femoral subtrochanteric fracture/Seinsheimer type-Ⅴ/closed reduction intramedullary nailing fixation/open reduction intramedullary nailing fixation分类
临床医学
