[1]喻鑫罡,郭彦杰,高悠水,等.多轴锁定钢板倒置与髓内钉治疗老年股骨粗隆下骨折的疗效分析[J].中华老年骨科与康复电子杂志,2017,(05):270-274.[doi:10.3877/cma.j.issn.2096-0263.2017.05.004]
　Yu Xingang,Guo Yanjie,Gao Youshui,et al.Clinical effectiveness of reversive polyaxial locked plate and intramedullary nails for treatment of elderly femoral subtrochanteric fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):270-274.[doi:10.3877/cma.j.issn.2096-0263.2017.05.004]
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多轴锁定钢板倒置与髓内钉治疗老年股骨粗隆下骨折的疗效分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2017年05期
页码:
270-274
栏目:
髋部骨折
出版日期:
2017-09-18

文章信息/Info

Title:
Clinical effectiveness of reversive polyaxial locked plate and intramedullary nails for treatment of elderly femoral subtrochanteric fractures
作者:
喻鑫罡; 郭彦杰; 高悠水; 柴益民; 陆男吉
Author(s):
Yu Xingang;  Guo Yanjie;  Gao Youshui;  Chai Yimin;  Lu Nanji
Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
关键词:
内固定器;  股骨颈骨折;  老年人;  多轴锁定钢板
Keywords:
Internal fixators;  Femoral neck fractures;  Aged;  Polyaxial ; locked-plate
DOI:
10.3877/cma.j.issn.2096-0263.2017.05.004
文献标志码:
A
摘要:
目的 分析多轴锁定钢板倒置与髓内钉治疗老年股骨粗隆下骨折的临床疗效。方法 回顾性收集2009年4月至2015年4月上海交通大学附属第六人民医院骨科应用髓内钉与多轴锁定钢板倒置治疗的股骨粗隆下骨折82例，男性51例，女性31例，平均年龄为（69±10）岁。根据固定方式分为钢板组（n=40）和髓内钉组（n=42）。随访并记录患者的手术时间、C臂机透视次数、术中出血量、骨折愈合时间、并发症及术后髋关节功能评分（Harris评分）。结果 76例患者获满意随访，随访率为92.7%，随访时间为（30±9）个月。钢板组与髓内钉组的骨折愈合时间及Harris评分比较，差异无统计学意义。钢板组的手术时间[（66±11）min]、透视次数[（4.1±2.5）次]，显著低于髓内钉固定组[（78±20）min、（12.1±3.2）次]，差异具有统计学意义（t=3.110，t=8.452，P＜0.05），而髓内钉组的术中失血量[（190±27）ml]显著低于钢板组[（446±20）ml]，差异有统计学意义（t=20.348，P＜0.05）。髓内钉组出现并发症较多（c2=7.121，P＜0.05），但是两组髋关节功能评分无统计学差异。结论 对于股骨粗隆下骨折，如果外侧壁完好，两种治疗方法均可达到很好的疗效。如果外侧壁冠状面破裂，尤其伴有内侧柱骨折，多轴锁定钢板倒置治疗老年股骨粗隆下骨折具有手术时间短、C臂机透视次数少的优势。
Abstract:
Objective To study the clinical effects of polyaxial locked plate and intramedullary nails for the treatment of elderly femoral subtrochanteric fractures. Methods All 82 patients with femoral subtrochanteric fractures were treated by reverse polyaxial locked plate and intramedullary nails from April 2009 to April 2015. There were 51 males and 31 females. The average age was 69±8 years. Patients were divided into locking plate group (40 cases) and intramedullary group (42 cases). Operation time, times of X rays, total blood loss, bone healing time, complications and Harris scores were followed and compared between two groups. Results 76 cases were followed up for (30±9) months. There were no significant differences in bone healing time and Harris scores between two groups; the operation time (66±11 min vs 78±20 min), times of X rays (4.1±2.5 vs 12.1±3.2) in locked plate group was lower than that in extramedullary group with statistical significance (t=3.110, t=8.452, P<0.05), and the blood loss (446±20 ml vs 190±27 ml) of locked-plate group was higher than that in extramedullary group, with statistical significance (t=20.348, P<0.05) . Even though the locked plate group had lower incidence of major complications (c2=7.121, P<0.05). Conclusion When the lateral wall was completed, both two kinds of internal fixations are applicable for subtrochanteric fractures. If the medial side and lateral side of the trochanter were incompleted, the polyaxial locked plate plate had the advantages of short operated time, reliable fixation and less fluoroscopy times.

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备注/Memo

备注/Memo:
基金项目：上海市科委医学重点项目（11411950400）
更新日期/Last Update: 2017-09-15