摘要
目的探讨有限切开InterTan髓内钉治疗股骨转子下骨折的疗效。方法采用有限切开InterTan髓内钉治疗33例股骨转子下骨折患者。记录手术时间、术中出血量、并发症发生情况、骨折复位情况、骨折愈合情况、疼痛VAS评分、膝关节活动度。采用Harris评分评价髋关节功能。结果患者均获得随访,时间1~2(1.2±0.4)年。手术时间65~123(100.8±23.8)min;术中出血量160~750(342.7±98.5)ml。术中及术后均无并发症发生。20例解剖复位,15例功能复位。术后6~8周可见骨折端骨痂形成,骨折端复位未见丢失,骨折线模糊。患者开始扶拐下地时间6~8(6.8±1.5)周。骨折均愈合,时间7~11(8.2±2.4)个月。末次随访时,Harris评分78~100(91.3±12.7)分,其中优21例,良9例,可3例,优良率30/33;疼痛VAS评分0~3(0.7±0.4)分;膝关节活动度:伸展-2°~0°,屈曲135°~150°;28例可完全负重行走,5例可扶拐行走。结论采用有限切开InterTan髓内钉治疗股骨转子下骨折可获得满意的临床疗效。
Objective To investigate the efficacy of limited open and the InterTan intramedullary nail in the treatment of femoral subtrochanteric fractures.Methods The 33 patients with femoral subtrochanteric fractures were treated with limited open and InterTan intramedullary nail.The following data were recorded,including the operation time,intraoperative blood loss,complications and fracture reduction,and fracture healing situation,pain VAS,the range of motion of knee joint.Harris socre was used to evaluate the hip function.Results All patients were followed up foR1~2(1.2±0.4)years.The operation time was 65~123(100.8±23.8)min;the intraoperative blood loss was 160~750(342.7±98.5)ml.No complications occurred during oRafteRthe operation.Anatomical reduction was obtained in 20 patients,and functional reduction was obtained in 15 patients.At 6~8 weeks afteRoperation,there were callus formation at the fractured site,no loss of fracture reduction,and indistinct fracture line.The patient began to walk with crutches at 6~8(6.8±1.5)weeks postoperation.All fractures healed within 7~11(8.2±2.4)months.At the last follow-up,Harris scores was 78~100(91.3±12.7)points,21 cases were excellet,9 cases were good,and 3 cases fair,the excellent and good rate was 30/33;pain VAS was 0~3(0.7±0.4)points;knee range of motion:extension with-2°~0°,flexion with 135°~150°;28 cases could walk with full weight-bearing,5 cases could walk with crutches.Conclusions The satisfactory clinical results can be obtained in the the femoral subtrochanteric fractures treated with limited open and InterTan intramedullary nail。
作者
李利
张泰标
张志伟
甘发荣
LI Li;ZHANG Tai-biao;ZHANG Zhi-wei;GAN Fa-rong(Dept of Orthopaedics,the Chinese Medicine Hospital of Hainan Province,Haikou,Hainan 570203,China)
出处
《临床骨科杂志》
2022年第2期260-263,共4页
Journal of Clinical Orthopaedics
