本文選題：骨質(zhì)疏松性骨折 + 股骨骨折　； 參考：《解放軍醫(yī)學(xué)雜志》2017年08期

【摘要】：目的探討微創(chuàng)內(nèi)固定治療老年骨質(zhì)疏松不穩(wěn)定股骨轉(zhuǎn)子間骨折的方法及療效。方法回顧性分析2009年1月-2015年9月采用Intertan或短重建釘(TAN)內(nèi)固定微創(chuàng)治療的112例老年性骨質(zhì)疏松股骨轉(zhuǎn)子間骨折患者的臨床資料。所有患者均結(jié)合病史、查體及影像學(xué)檢查進(jìn)行診斷,按照AO分型,31-A.1型34例,31-A.2型61例,31-A.3型17例。對(duì)手術(shù)時(shí)間、透視時(shí)間、術(shù)中失血量、住院天數(shù)、并發(fā)癥及髖關(guān)節(jié)功能評(píng)分等進(jìn)行統(tǒng)計(jì)分析。結(jié)果 112例患者中78例獲隨訪,隨訪時(shí)間3~27個(gè)月(平均15個(gè)月),其中Intertan組41例,TAN組37例。Intertan組手術(shù)時(shí)間、透視時(shí)間(分別為58.9±6.9、2.70±0.47min)明顯短于TAN組(分別為75.6±5.9、4.40±0.47min),術(shù)中出血量(107.6±6.7ml)明顯低于TAN組(127.8±6.8ml),髖關(guān)節(jié)Harris評(píng)分優(yōu)良率(73%)高于TAN組(65%),術(shù)后并發(fā)癥發(fā)生率(4.9%)低于TAN組(10.8%),差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組住院天數(shù)、骨折愈合時(shí)間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論Intertan和TAN兩種微創(chuàng)固定方法治療不穩(wěn)定股骨轉(zhuǎn)子間骨折均可取得較好的臨床療效,其中Intertan具有操作簡單、固定可靠、出血少、髖關(guān)節(jié)功能恢復(fù)好、并發(fā)癥少等優(yōu)點(diǎn),是治療老年骨質(zhì)疏松不穩(wěn)定股骨轉(zhuǎn)子間骨折的良好選擇。
[Abstract]:Objective to explore the method and effect of minimally invasive internal fixation in the treatment of unstable intertrochanteric fracture of the femur. Methods the clinical data of 112 patients with senile osteoporosis intertrochanteric fracture treated with intertan or short reconstruction nail (Tan) from January 2009 to September 2015 were retrospectively analyzed. All the patients were diagnosed with history, physical examination and imaging examination. 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. The operative time, fluoroscopy time, blood loss during operation, hospitalization days, complications and hip function score were analyzed statistically. Results 78 of 112 patients were followed up for 3 ~ 27 months (mean 15 months). Among them, 41 cases in Intertan group, 37 cases in Tan group, 37 cases in Intertan group, were followed up for 3 ~ 27 months (mean, 15 months). The fluoroscopy time (58.9 鹵6.9 鹵2.70 鹵0.47min) was significantly shorter than that in Tan group (75.6 鹵5.9 鹵4.40 鹵0.47min, respectively), the intraoperative bleeding volume (107.6 鹵6.7ml) was significantly lower than that in Tan group (127.8 鹵6.8ml), the excellent and good rate of hip Harris score (73%) was higher than that in Tan group (65%), and the incidence of postoperative complications (4.9%) was significantly lower than that in Tan group (10.8%) (P0.05). There was no significant difference in hospitalization days and fracture healing time between the two groups (P0.05). Conclusion Intertan and Tan are two minimally invasive fixation methods for unstable intertrochanteric fracture of femur. Intertan has the advantages of simple operation, reliable fixation, less bleeding, good recovery of hip joint function and less complications. It is a good choice for the treatment of unstable femoral intertrochanteric fracture.
【作者單位】： 浙江省立同德醫(yī)院創(chuàng)傷骨科;
【基金】：浙江省自然科學(xué)基金(LY13H060011)~~
【分類號(hào)】：R580;R687.3

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本文編號(hào)：2097507