摘要
目的探讨采用有限切开持骨钳复位结合加长型InterTan髓内钉固定治疗SeinsheimerⅤ型股骨转子下骨折的临床疗效。方法回顾性分析2015年1月至2018年6月收治的22例股骨转子下骨折患者的资料,男14例,女8例;年龄(62.95±12.44)岁(范围36~81岁);骨折均为SeinsheimerⅤ型。所有股骨转子下骨折均采用有限切开持骨钳复位及加长型InterTan髓内钉固定,其中7例伴有较大蝶形骨块者附加单根钛缆环扎辅助固定。记录手术时间、术中失血量及并发症发生情况。术后采用Baumgartner标准评价骨折复位质量;末次随访时采用Harris评分标准评价髋关节功能,采用视觉模拟评分(visual analogue scale,VAS)评价髋部疼痛程度。结果22例患者均获得随访,随访时间(18±5.33)个月(范围12~30个月)。术后根据Baumgartner标准评价复位质量,其中解剖复位20例,复位可2例;骨折均愈合,愈合时间(4.36±1.36)个月(范围3~8个月)。末次随访时,Harris髋关节功能评分(89.05±7.75)分(范围71~100分),其中优11例,良8例,可3例,优良率为86.4%(19/22);VAS评分(0.64±0.85)分(范围0~3分)。2例患者术后双下肢不等长,均小于10 mm;随访期间无一例发生感染、下肢深静脉血栓形成、骨不连、头颈钉切割股骨头和内固定断裂等并发症。结论采用有限切开持骨钳复位结合加长型InterTan髓内钉固定治疗SeinsheimerⅤ型股骨转子下骨折,具有操作简单、利于复位、骨折端稳定性好等特点,术后疗效满意,并发症少。
Objective To describe the surgical technique and explore clinical and radiological outcomes of Seinsheimer V subtrochanteric femoral fractures treated by clamp-assisted reduction with limited incision and InterTan nailing fixation.Methods Data of 22 patients with Seinsheimer V subtrochanteric femoral fractures who were treated by clamp-assisted reduction and InterTan nailing fixation with limited incision in our hospital from January 2015 to June 2018 were retrospectively analyzed.There were 14 men and 8 women with an average age of 62.95±12.44 years(range,36-81 years).Among them,7 cases with a big butter-fly fragment were fixed by one cable.After the reduction,the fractures were fixed with InterTan nailing.The operative time,intraoperative blood loss and postoperative complication were recorded.The reduction quality was assessed by postoperative radiography according to the criteria proposed by Baumgartner.The function of the hip joint was assessed by the Harris score and VAS score.Results All patients were followed up for 18±5.33 months(range,12-30 months).According to the Baumgartner criteria of reduction quality,anatomic reduction was obtained in 20 cases,and satisfactory reduction was gained in 2 cases.All fractures healed in 4.36±1.36 months(range,3-8 months).At latest follow-up,the mean Harris scores was 89.05±7.75(range,71-100 points),including 11 cases of excellent,8 cases good,and 3 cases fair(satisfactory rate=86.4%).The mean VAS score was 0.64±0.85(range,0-3 points).Two patients had limb length discrepancy which was less than 10 mm.There were no significant complications such as infection,deep vein thrombosis,nonunion,nail cut out and implant failure.Conclusion Clamp-assisted reduction and InterTan nailing with limited incision for Seinsheimer V subtrochanteric femoral fractures is simple and easy to manipulate,which can achieve anatomic reduction and has good clinical effects.
作者
王勇
蒋建农
都斌
陈俊
王强
李贺
张盘军
Wang Yong;Jiang Jiannong;Du Bin;Chen Jun;Wang Qiang;Li He;Zhang Panjun(Department of Orthopaedics,the Affiliated Yixing Hospital of Jiangsu University,Yixing 214200,China)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2020年第19期1318-1326,共9页
Chinese Journal of Orthopaedics
基金
江苏省自然科学基金面上项目(BK20191150)。
关键词
髋骨折
骨折固定术
髓内
外科手术
微创性
Hip fractures
Fracture fixation,intramedullary
Surgical procedures,minimally invasive
