摘要
目的比较采用微创技术(MIS)置入内锁股骨近端髓内钉(ITST)与普通股骨近端髓内钉(PFN)内固定治疗股骨粗隆间骨折的临床疗效。方法采用前瞻性研究,将2007年1月～2008年1月收治的62例股骨粗隆间骨折患者随机分为微创ITST组和普通PFN组。其中微创ITST组在完成复位后经特殊器械导引置入ITST,普通组患者按常规方法置入PFN固定。记录两组的手术时间、术中失血量、切口长度、术后输血例数和骨折愈合时间并进行比较。结果1例患者死亡,4例失访。微创ITST组平均手术时间、失血量、切口长度及输血例数均明显低于普通PFN组,差异有显著性意义(P<0.01),两组患者骨折临床愈合时间和平均住院时间无显著差异(P>0.05)。两组所有骨折均愈合,无延迟愈合与不愈合。结论与普通PFN相比,微创置入ITST治疗股骨粗隆间骨折创伤小、失血量少、早期临床疗效更令人满意。
Objective To evaluate the clinical results of interlocking proximal femoral nail （ITST） inserted through minimally invasive surgery （MIS） and routine proximal femoral nail （PFN） fixation for the femoral intertrochanteric fractures in the elderly. Methods From January of 2007 to January of 2008, 62 patients with femoral intertrochanteric fractures at the average of 78.4 years old were operated. Thirty cases were operated with interlocking proximal femoral nail （ITST） through minimally invasive surgery （MIS） while 32 cases with PFN. Data related to incision length, operation time, blood loss volume, drainage amount, blood transfusion amount were recorded separately.Results Fifty-seven cases were followed up （one died in accident; one in ITST group and 3 in PFN group lost of follow-up） at least 12-18 months. There was no difference in year, fracture type, fracture healing time and duration of hospitalization （P〉0.05）. ITST with MIS group showed less blood loss, drainage amount, fewer number of blood transfusion cases and shorter incision length than that in PFN group （P〈0.01）. Conclusion Interlocking proximal femoral nail （ITST） inserted through MIS is one of the ideal choices for the treatment of femoral intertrochanteric fractures in the elderly with less blood loss and more rapidly recovery.
出处
《中国骨与关节损伤杂志》
2010年第1期19-21,共3页
Chinese Journal of Bone and Joint Injury
关键词
股骨粗隆间骨折
内锁股骨近端髓内钉
微创手术
Femoral intertrochanteric fractures
Interlocking proximal femoral nail
Minimally invasive surgery
