摘要
目的比较采用经皮微创置入内锁股骨近端髓内钉(ITST)与普通股骨近端髓内钉(PFN)内固定治疗骨质疏松性股骨粗隆间骨折的临床疗效。方法 采用前瞻性研究,将2007年3月至2008年4月收治的64例骨质疏松性股骨粗隆间骨折患者随机分为微创ITST组和普通PFN组。其中微创组在完成复位后经特殊器械导引置入内锁股骨近端髓内钉(ITST),普通组患者按常规方法置入股骨近端髓内钉(PFN)固定。记录两组的手术时间、术中失血量、切口长度、术后输血例数和骨折愈合时间并进行比较。结果1例患者死亡。4例失访。ITST组平均手术时间、失血量、切口长度及输血例数均明显低于普通组,差异有极显著性意义(p<0.01)两组患者骨折临床愈合时间和平均住院时间无显著差异(p>0.05)。两组所有骨折均愈合,无延迟愈合与不愈合。结论 与普通股骨近端髓内钉相比,经皮微创置入锁定股骨近端髓内钉(ITST)治疗股骨转子间骨折创伤小,失血量少,早期临床疗效更令人满意。
Objective To compare the clinical efficacy of interlocking proximal femoral nail （ITST） inserted by minimal invasive surgery （M1S） and routine proximal femoral nail （PFN） fixation for the treatment of osteoporotic intertrochanterie fractures. Methods In this prospective study, 64 patients with osteoporotic intertrochanteric fractures were randomly divided into ITST group and PFN group from march 2007 to april 2008. ITST was inserted after relocalization by a special equipment in ITST group, while PFN was inserted with routine method in PFN group. Operation time, blood loss volume, incision length, blood transfusion cases, and fracture healing time were recorded and compared in both groups. Results One patient died. Four patients were lost during follow-up. The average operating time, blood loss, incision length, and blood transfusion cases in ITST group were significantly decreased than those in PFN group （P 〈 0. 01 ）. There were no differences in fracture healing time and duration of hospitalization between the two groups （P 〉 0.05）. All fractures were healed and no delayed healing or non-healing found. Conclusion Comparing to PFN, 1TST inserted by MIS is the treatment with minimal damage, less blood loss, and better early clinical efficacy for intertrochanteric fractures.
出处
《中国骨质疏松杂志》
CAS
CSCD
2010年第11期859-862,共4页
Chinese Journal of Osteoporosis
关键词
骨质疏松
股骨粗隆间骨折
微创手术
Osteoporosis
Intertrochanterlc fractures
Minimally invasive surgery
