摘要
目的:探讨阳性支撑、阴性支撑、中性支撑对老年股骨粗隆间骨折γ-Ⅱ型带锁髓内钉闭合复位内固定疗效的影响。方法:回顾性分析2014年1月~2019年6月我院骨科应用股骨近端髓内钉(γ-Ⅱ型带锁髓内钉)闭合复位内固定治疗股骨粗隆间骨折90例,年龄60~88岁,平均(74.98±6.82)岁。根据术后髋关节正位X线片中股骨干内侧皮质与股骨颈内侧骨皮质的位置关系分为3组:阳性支撑组49例、阴性支撑组25例、中性支撑组16例。比较三组患者的性别,年龄,骨密度,骨折类型,术后即时尖顶距(TAD),术后1年尖顶距(TAD)、颈干角、股骨颈长度变化,术后1年髋关节功能Harris评分优良率,并发症发生率。结果:三组患者年龄、性别、骨折类型、骨密度、术后即时TAD比较差异无统计学意义。阳性支撑组和中性支撑组患者TAD、术后1年颈干角、股骨颈长度变化、术后1年髋关节功能Harris评分比较无明显差异;阳性支撑组与阴性支撑组、中性支撑组与阴性支撑组患者TAD、术后1年颈干角、股骨颈长度变化、术后1年髋关节功能Harris评分比较具有明显差异。中性、阳性支撑组未见并发症,阴性支撑组并发症发生率为12.5%。结论:对老年股骨粗隆间骨折利用γ-Ⅱ型带锁髓内钉闭合复位内固定相关治疗中,可取得比较满意的疗效,阳性支撑、中性支撑组稳定性明显优于阴性支撑。
Objective To study effect of positive support,negative support and neutral support on closed reduction and internal fixation ofγ-Ⅱtype intramedullary locking nail in elderly femoral intertrochanteric fracture.Methods Retrospective analysis of 90 cases of intertrochanteric fracture of femur treated by closed reduction and internal fixation of proximal femoral intramedullary nail(γ-Ⅱtype with locking intramedullary nail)in orthopaedics of our hospital from january 2014~june 2019,aged 60~88,with an average(74.98±6.82)years.According to the position relationship between the medial femoral shaft cortex and the medial femoral neck cortex in the positive X line of hip joint after operation,it was divided into 3 groups:49 positive support group,25 negative support group and 16 neutral support group.The sex,age,bone mineral density,fracture type,immediate apical distance(TAD)and apical distance(TAD)1 year after operation,neck dry angle,femoral neck length change,1 year after operation hip function Harris score excellent and good rate,complication rate.Results Age,sex,fracture type,bone mineral density and immediate postoperative TAD were not statistically significant in the three groups.There was no significant difference in TAD、neck angle,femoral neck length,hip function Harris score in 1 year after operation between positive support group and neutral support group.There were significant differences between positive support group and negative support group,neutral support group and negative support group TAD、the change of neck dry angle,femoral neck length and hip function Harris score in 1 year after operation.No complications were found in neutral and positive support group.The complication rate of negative support group was 12.5%.Conclusion For the elderly intertrochanteric fracture,γ-Ⅱtype of closed reduction and internal fixation with locking intramedullary nail can obtain satisfactory results.The stability of positive support and neutral support group was significantly better than that of negative support.
作者
罗田
彭成忠
吴财
曾庆虎
廖涛
王乐乐
Luo Tian;Peng Cheng-zhong;Wu Cai;Zeng Qing-hu;Liao Tao;Wang Le-le(Department of Orthopedics Xiangdong Hospital of Hunan Normal University,Liling 412200,China)
出处
《湖南师范大学学报（医学版）》
2020年第4期7-10,共4页
Journal of Hunan Normal University(Medical Sciences)
基金
湖南省教育厅一般基金项目(NO.19C1161)
关键词
股骨粗隆间骨折
支撑
内固定
疗效
intertrochanteric fracture
support
internal fixation
efficacy
