摘要
目的比较髓外固定与髓内固定治疗不同类型股骨转子间骨折的临床效果,为不同类型股骨转子间骨折选择合适的内固定方法提供依据。方法 129例股骨转子间骨折患者根据内固定方法分为髓外固定组(n=48)和髓内固定组(n=81),对2组患者的临床治疗效果进行比较。结果髓外固定组A1、A2、A3型骨折患者治疗优良率分别为95.0%、82.4%、45.6%,A1、A2、A3型骨折治疗优良率逐渐降低(P<0.05);髓外固定组A1、A2、A3型骨折患者髋关节功能评分分别为54.4±4.7、48.6±4.5、46.2±6.3,A1、A2、A3型骨折患者髋关节功能评分逐渐降低(P<0.05)。髓内固定组A1、A2、A3型骨折患者治疗优良率分别为84.2%、82.1%、93.3%,差异无统计学意义(P>0.05);髓内固定组A1、A2、A3型骨折患者髋关节功能评分分别为50.1±4.2、49.4±5.0、54.0±4.8,差异有统计学意义(P<0.05)。2组A1型骨折患者治疗优良率比较差异无统计学意义(P>0.05),但髓外固定组A1型骨折患者髋关节功能评分高于髓内固定组(P<0.05);2组A2型骨折患者治疗优良率及髋关节功能评分比较差异均无统计学意义(P>0.05);髓内固定组A3型骨折患者治疗优良率及髋关节功能评分均显著高于髓外固定组(P<0.05)。结论 A1型股骨转子间骨折优先考虑髓外固定,A3型股骨转子间骨折应首选髓内固定;对于A2型股骨转子间骨折,需根据患者年龄、身体对手术的耐受力、骨骼质量进行综合评估,选择合适的内固定方式。
Objective To provide the basis for selecting suitable internal fixation methods by comparing the clinical effect of extramedullary fixation and intramedullary fixation in the treatment of different types of femoral intertrochanteric fracture. Methods A total of 129 patients with femoral intertrochanteric fractures were divided into extramedullary fixation（ n =48） group and intramedullary fixation group（ n = 81） according to internal fixation method,then the effect was compared between the two groups. Results The fineness rate of patients with type A1,A2 and A3 fracture in extramedullary fixation group was 95. 0%,82. 4% and 45. 6% respectively,the fineness rate decreased gradually（ P〈0. 05）. The hip joint function score of patients with type A1,A2 and A3 fracture in extramedullary fixation group was 54. 4 ± 4. 7,48. 6 ± 4. 5 and 46. 2 ± 6. 3 respectively,the score decreased gradually（ P〈0. 05）. The fineness rate of patients with type A1,A2 and A3 fracture in intramedullary fixation group was 84. 2%,82. 1% and 93. 3% respectively,the difference was not statistically significant（ P〈0. 05）. The hip joint function score of patients with type A1,A2 and A3 fracture in intramedullary fixation group was 50. 1 ± 4. 2,49. 4 ±5. 0 and 54. 0 ± 4. 8 respectively,the difference was statistically significant（ P〈0. 05）. There was no significant difference in the fineness rate of patients with type A1 fracture between the two groups（ P〈0. 05）,but the hip joint function score of patients with type A1 fracture in extramedullary fixation group was higher than that in intramedullary fixation group（ P〈0. 05）.There was no significant difference in the fineness rate and hip joint function score of patients with type A2 fracture between the two groups（ P〈0. 05）. The fineness rate and hip joint function score of patients with type A3 fracture in intramedullary fixation group were higher than those in extramedullary fixation group（ P〈0. 05）. Conclusions Type A1 femoral intertrochanteric fracture should be treated with extramedullary fixation,and intramedullary fixation should be the first choice for type A3 fracture. The suitable internal fixation for type A2 fracture should be selected according to age,tolerance and bone status of patients.
出处
《新乡医学院学报》
CAS
2015年第7期663-665,共3页
Journal of Xinxiang Medical University
关键词
股骨转子间骨折
髓外固定
髓内固定
femoral intertrochanteric fracture
extramedullary fixation
intramedullary fixation
