摘要
目的:探讨主钉开口处取骨植骨在股骨粗隆下骨折髓内钉内固定术中的应用价值。方法:将2019年1月至2021年9月收治的符合纳入标准的股骨粗隆下骨折患者60例纳入研究,根据患者入组顺序随机分成两组,各30例。对照组单纯采用髓内钉常规治疗,观察组在对照组基础上加用主钉开口处取骨植骨。对两组患者手术时间、术中出血量、骨折复位情况、术后并发症、骨折愈合率和髋关节功能进行临床随访分析。结果:所有患者均按要求进行随访,随访时间为10~24个月,平均(15.3±3.2)个月,两组患者的手术时间、术中出血量及骨折复位情况比较,差异均无统计学意义(P>0.05);两组患者术后并发症、骨折愈合率和髋关节功能对比,差异有统计学意义(P<0.05)。结论:在股骨粗隆下骨折髓内钉内固定术中采用主钉开口处取骨并植骨,其操作简单,不增加手术步骤,骨折愈合率更高,术后患肢功能恢复更好,且并发症少,这种无额外医源性创伤和排异反应的植骨技术值得广大临床骨科医师参考应用。
Objective:To investigate the application value of bone grafting at the main nail opening in intramedullary nail fixation on subtrochanteric fracture of femur.Methods:60 patients with subtrochanteric fracture of femur who meeting the inclusion criteria were included in the study from January 2019 to September 2021.According to the order of inclusion,the patients were randomly divided into two groups with 30 patients in each group.The control group was treated with intramedullary nailing alone,and the observation group was treated with bone grafting at the main nail opening on the basis of the control group.The operative time,intraoperative blood loss,fracture reduction,postoperative complications,fracture healing rate and hip function of the two groups were analyzed in clinical follow-up.Results:All patients were followed up as required for 10 to 24 months,with(15.3±3.2)months on average.There were no significant differences in operative time,intraoperative blood loss and fracture reduction between the two groups(P>0.05).There were significant differences in postoperative complications,fracture healing rate and hip function between the two groups(P<0.05).Conclusion:The technique of bone grafting at the main nail opening in intramedullary nail fixation on subtrochanteric fracture of femur is simple in operation,and does not increase the operation steps,with higher fracture healing rate,better recovery of limb function and fewer complications.The bone implant technique has no additional iatrogenic trauma and rejection of the graft,which is worth the clinical orthopedic surgeon’s reference.
作者
吴天然
陈夏平
王瑞雄
林江游
叶志强
张昭兴
敖庆芳
邹许亭
吴振斌
WU Tianran;CHEN Xiaping;WANG Ruixiong;LIN Jiangyou;YE Zhiqiang;ZHANG Zhaoxing;AO Qingfang;ZOU Xuting;WU Zhenbin(Quanzhou Orthoprdic-Traumatological Hospital,Quanzhou 362000,Fujian China)
出处
《中国中医骨伤科杂志》
CAS
2022年第7期38-43,48,共7页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
泉州市科学技术局项目(2020N076s)。
关键词
股骨粗隆下骨折
骨折固定术
髓内钉
植骨
subtrochanteric fracture of femur
fracture fixation
intramedullary nail
bone grafting
