本文選題：股骨粗隆間骨折　切入點：Inter　出處：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]分析內(nèi)側(cè)皮質(zhì)正性支撐復(fù)位在聯(lián)合加壓交鎖髓內(nèi)釘系統(tǒng)(tri Gen intertan hip fracture nailing system,Inter TAN)內(nèi)固定治療股骨粗隆間骨折時臨床效果的影響。[方法]回顧性分析我院2013年2月至2016年1月采用Inter TAN治療的不穩(wěn)定型順向股骨粗隆間骨折(AO/OTA 31A2型)患者68例,其中男30例,女38例,年齡61-84歲,平均(70.43±6.058)歲。依據(jù)術(shù)后即刻標準正側(cè)位X線片上近端頭頸側(cè)骨塊內(nèi)側(cè)皮質(zhì)與遠端股骨干內(nèi)側(cè)皮質(zhì)的位置關(guān)系分為3組:內(nèi)側(cè)皮質(zhì)正性支撐(36例),內(nèi)側(cè)皮質(zhì)中性支撐(24例),內(nèi)側(cè)皮質(zhì)負性支撐(8例)。比較三組患者的術(shù)前一般臨床資料,手術(shù)時長、術(shù)中出血量、住院時間、術(shù)后并發(fā)癥發(fā)生率、尖頂距(TAD)、頸干角、股骨頸長度變化及術(shù)后6個月隨訪時髖關(guān)節(jié)Harris評分等。[結(jié)果]三組患者在年齡、性別比、手術(shù)時長、術(shù)中出血量、住院時間、尖頂距等方面無統(tǒng)計學(xué)差異(P0.05)。術(shù)后3個月頸干角及股骨頸長度丟失內(nèi)側(cè)皮質(zhì)正性支撐組低于負性支撐組,差別有統(tǒng)計意義(P0.01)。術(shù)后隨訪6個月髖關(guān)節(jié)Harris評分內(nèi)側(cè)皮質(zhì)正性支撐組優(yōu)良率高于負性支撐組,而并發(fā)癥發(fā)生率則較低,差別有統(tǒng)計意義(P0.05)。[結(jié)論]內(nèi)側(cè)皮質(zhì)正性支撐復(fù)位可使頭頸骨塊與股骨干之間獲得更穩(wěn)定的接觸面,為骨折愈合提供良好的生物力學(xué)條件,可以讓患者更早下地進行功能鍛煉,減少術(shù)后并發(fā)癥的發(fā)生。
[Abstract]:[Objective] analysis of the medial cortex positive support reduction in compression interlocking intramedullary nail system (tri Gen intertan hip fracture nailing system, Inter TAN)]. Methods in the treatment of femoral intertrochanteric fracture clinical effect of unstable type of retrospective analysis of our hospital from February 2013 to January 2016 by Inter TAN for the CIS the fracture of femoral intertrochanteric (AO/OTA 31A2) 68 cases, male 30 cases, female 38 cases, age 61-84 years, average (70.43 + 6.058) years old. According to standard and immediate postoperative X-ray on the proximal side of head and neck bone medial cortex position between the distal femoral medial cortex divided into 3 groups: the medial cortex is supporting the medial cortex (36 cases), neutral support (24 cases), the medial cortex negative support (8 cases). Patients in the preoperative clinical data in three groups, operation time, amount of bleeding, hospitalization time, postoperative complications tip. From the top of the neck shaft angle (TAD), and 6 months follow-up changes and postoperative length of femoral neck hip joint Harris score. Results: three groups of patients in age, sex ratio, operation time, bleeding volume, operation time, no significant difference from the aspects of spire (P0.05) 3. April collodiaphyseal angle and femoral neck length loss of medial cortex positive support group was lower than that of negative support group, the difference was statistically significant (P0.01). After 6 months of follow-up Harris hip score of the medial cortex positive support group was higher than that of negative support group, and the complication rate is low, poor don't have statistical significance (P0.05). Conclusion] the medial cortex is supporting reduction makes it possible to obtain a more stable contact surface between bone and femoral neck fracture healing, to provide biomechanical conditions are good, can let the patient to early functional exercise, reduce the incidence of postoperative complications.

【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3
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本文編號：1656414