摘要
目的设计股骨近端投影标记的方法，以优化股骨顺行髓内钉的手术过程，从而提高股骨转子问骨折和股骨干骨折的手术疗效。方法回顾性分析2012年1月至2016年1月期间温州医科大学附属第一医院骨科收治的198例股骨转子间骨折（158例）和股骨干骨折（40例）患者资料。男61例，女137例；年龄（65．4±14．6）岁，年龄范围为13～95岁。骨折AO分型：31-A1型55例，31-A2型103例；32-A2型21例，32-A3型19例。按照入院时间顺序、骨折类型和是否采用投影标记法进行分组：2012年1月至2013年5月未采用投影标记法患者分别纳入股骨转子间骨折．非投影标记组（A1组61例）和股骨干骨折一非投影标记组（Sl组12例）；2013年5月至2016年1月采用投影标记法的患者分别纳入转子问骨折一投影标记组（A2组97例）和股骨干骨折．投影标记组（B2组28例）。分别比较A1组和A2组之间，B1组和B2组之间总手术时间、总透视次数、术后第3个月Harris髋关节功能评分（HHS）、膝关节损伤和骨关节炎结果评分（KOOS）中的疼痛评分和症状评分以及并发症发生情况。结果198例患者术后获3～18个月（平均7．0个月）随访。A2组总手术时间[（56．5±6．6）min]和总透视次数[（26．6±6．2）次]均小于A1组[（59．2±9．2）min和（31．4±9．9）次]，差异均有统计学意义（P〈0．05）。B2组总手术时间[（84．6±16．1）min]小于B1组[（97．8±17．9）min]，差异有统计学意义（P〈0．05）。B2组总透视次数（49．4±12．7）次，少于B1组（50．6±10．1）次，但差异无统计学意义（P〉0．05）。结论对于股骨转子间骨折和股骨干骨折，设计的体表投影标记方法可以优化股骨顺行髓内钉的手术过程，能够明显缩短手术时间、减少术中透视次数。
Objective To evaluate the projection marking which was designed to improve the surgical efficiency of antegrade femoral intramedullary nailing for femoral intertrochanteric and shaft fractures. Methods A total of 198 patients （158 femoral intertrochanteric fractures and 40 femoral shaft fractures） were analyzed retrospectively who had been treated at Department of Orthopedics, The First Affiliated Hospital to Wenzhou University from January 2012 to January 2016. They were 61 males and 137 females, aged from 13 to 95 years （mean, 65.4 ± 14. 6） . By AO classification, there were 55 cases of type 31-A1, 103 cases of type 31-A2, 21 cases of type 32-A2 and 19 cases of type 32-A3. The intertrochanteric fractures which had been treated from January 2012 to May 2013 with no projection marking were assigned into group A1 （ n = 61 ） while the shaft fractures which had been treated in the same period with no projection marking into group B1 （ n = 12）; the intertrochanteric fractures which had been treated from May 2013 to January 2016 with projection marking were assigned into group A2 （ n = 97） while the shaft fractures which had been treated in the same period with projection marking into group B2 （n = 28）. Comparisons were made between groups A1 and A2, and between groups B1 and B2 in terms of total operative time, total number of fluoroscopy, complications, Harris hip score （HHS）, and pain and symptoms scores in Knee Injury and Osteoarthritis Outcome Score （KOOS） 3 months after operation. Results The 198 patients were followed up for 3 to 18 months （average, 7.0 months）. The total operative time （56. 5 ± 6.6 min） and the total number of fluoroscopy （26. 6±6. 2 times） in group A2 were significantly less than those in group A1 （59.2±9.2 min and 31.4±9.9 times） （ P 〈 0. 05）. The total op-erative time （84, 6 ± 16. 1 min） in group B2 was significantly less than that in group B1 （97, 8 - 17.9 min） （ P 〈 0. 05） but the total number of fluoroscopy （49.4
作者
刘扬波
陈廖斌
秦俊
陈雷
Liu Yangbo;Chen Liaobin;Qin Jun;Chen Lei(Department of Orthopedics,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Department of Orthopedics,The First Affiliated Hospital to Wenzhou University,Wenzhou 325000,Zhejiang,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2018年第7期627-633,共7页
Chinese Journal of Orthopaedic Trauma
关键词
股骨骨折
骨折内固定术
内
骨钉
透视投影定位
Femoral fractures
Fracture fixation
internal
Bone nails
Projection marking
