摘要
目的探讨不同长度的髓内钉治疗合并骨质疏松的不稳定型股骨转子间骨折的疗效。方法回顾性分析2017年1月至2019年12月中日友好医院骨科收治的合并骨质疏松症的不稳定型股骨转子间骨折患者资料。根据采用的髓内钉长度不同分为两组:短钉组135例,男38例,女97例;年龄(82.2±7.7)岁;采用长度为170 mm的髓内钉固定。长钉组32例,男8例,女24例;年龄(81.5±7.1)岁;采用长度大于300 mm的髓内钉固定。比较两组患者术中血红蛋白下降值、手术时间、术后6个月Harris评分、并发症的发生率及病死率。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。两组患者的血红蛋白下降值[(19.8±2.2)g/L、(20.0±2.1)g/L]、Harris评分[(72.0±3.0)分、(71.2±3.6)分]、并发症的发生率[3.0%(4/135)、6.2(2/32)]及病死率[14.3%(19/135)、15.6%(5/32)]比较差异均无统计学意义(P>0.05)。与短钉组比较,长钉组具有更长的手术时间[(84.6±5.6)min、(92.0±7.2)min],差异有统计学意义(P<0.05)。结论长、短髓内钉在血红蛋白下降值、功能评分、并发症、病死率方面无明显差异,均可以提供安全、可靠的疗效。与短髓内钉比较,长髓内钉具有更长的手术时间。
Objective To investigate the effects of lengths of intramedullary nails on the treatment efficacy of osteoporotic unstable intertrochanteric fracture.Methods Retrospectively analyzed were the data of patients with osteoporotic unstable intertrochanteric fracture who had been admitted to Department of Orthopedics,China-Japan Friendship Hospital from January 2017 to December 2019.According to the lengths of intramedullary nails,the patients were divided into 2 groups.In the short nail group of 135 cases,there were 38 males and 97 females with an age of(82.2±7.7)years and an intramedullary nail with a length of 170 mm was used.In the long nail group of 32 cases,there were 8 males and 24 females with an age of(81.5±7.1)years and an intramedullary nail longer than 300 mm was used.The amount of intraoperative hemoglobin drop value,operation time,Harris hip score at 6 months after surgery,incidence of complications and mortality were compared between the 2 groups.Results There was no significant difference in the preoperative general data between the 2 groups,indicating comparability between groups(P>0.05).There were no significant differences between the 2 groups in intraoperative hemoglobin drop value[(19.8±2.2)g/L versus(20.0±2.1)g/L],Harris hip score(72.0±3.0 versus 71.2±3.6),incidence of complications[3.0%(4/135)versus 6.2(2/32)]or mortality[14.3%(19/135)versus 15.6%(5/32)](P>0.05).The long nail group needed significantly longer operation time than the short nail group[(84.6±5.6)min versus(92.0±7.2)min](P<0.05).Conclusions In the treatment of osteoporotic unstable intertrochanteric fracture,short and long intramedullary nails show no significant difference in hemoglobin drop value,functional score,complications or mortality,indicating they can both lead to safe and reliable curative efficacy.However,long nails need longer operation time.
作者
杨雨润
陈瀛
林朋
徐小东
杨欢
王立强
朱前拯
陈星佐
Yang Yurun;Chen Ying;Lin Peng;Xu Xiaodong;Yang Huan;Wang Liqiang;Zhu Qianzheng;Chen Xingzuo(Department of Orthopaedic,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第4期350-354,共5页
Chinese Journal of Orthopaedic Trauma
关键词
髋部骨折
骨质疏松
髓内钉
长钉
短钉
Hip fractures
Osteoporosis
Intramedullary nails
Long nail
Short nail
