前内侧皮质不同复位类型联合INTERTAN固定治疗股骨粗隆间骨折的疗效分析

doi:10.3969/j.issn.1007-3205.2020.05.013

摘要/Abstract

摘要： ［摘要］
目的探究前内侧皮质不同支撑复位联合顺行股骨髓内（Intertrochanteric Antegradenail，INTERTAN）固定对股骨粗隆间骨折的疗效。
方法回顾性分析股骨粗隆间骨折患者128 例。按照术后双髋正位 X 线片上头颈骨块前内侧皮质与股骨近端骨块前内侧皮质的对位关系，分为正性支撑组80例、中性支撑组23例和负性支撑组17例。比较3组患者术后即刻与术后3个月股骨颈干角和股骨颈长度变化量，首次患者负重下地时间以及术后3个月和6个月Harris评分差异情况。
结果负性支撑组和中性支撑组股骨颈长度和颈干角丢失量均多于正性支撑组，第1次患者负重下地时间均长于正性支撑组，负性支撑组股骨颈长度和颈干角丢失量均多于中性支撑组，第1次患者负重下地时间长于中性支撑组，差异均有统计学意义（P＜0.05）。负性支撑组和中性支撑组术后3个月和6个月Harris评分均少于正性支撑组，负性支撑组术后3个月和6个月Harris评分均少于中性支撑组，差异均有统计学意义（P＜0.05）。
结论前内侧皮质不同支撑复位联合INTERTAN固定，其中正性支撑和中性支撑组明显优于负性支撑组，可使骨折两端骨块充分接触，提高术后骨折的稳定性，恢复力线，减少术后并发症。

关键词: 粗隆间骨折, 复位, 正性支撑, INTERTAN

Abstract: ［Abstract］ Objective〖HTSS〗To explore the effect of different anterior cortical support reduction combined with an antegrade femoral intramedullary fixation on intertrochanteric fractures.
〖WTHZ〗Methods〖HTSS〗A retrospective analysis was performed on 128 patients who met the diagnostic criteria of intertrochanteric fracture.According to the contrastive relationship between the anterior medial cortex of the head and neck bone mass and the anterior medial cortex of the femoral shaft bone mass on the postoperative bilateral orthotopic X-ray, the patients were divided into positive support group(80 cases), neutral support group(23 cases) and negative support group(17 cases). The changes of femoral neck shaft angle and femoral neck length were compared among 3 groups of patients immediately and 3 months after operation, the time of the first time patients underwent weight-bearing,and the differences of Harris scores at 3 and 6 months after operation were compared.
〖WTHZ〗Results〖HTSS〗Femoral neck length and femoral neck shaft angle loss in the negative support group and the neutral support group were greater than that in the positive support group. The first time of weight-bearing was longer than that of the positive support group, the loss of femoral neck length and neck stem angle in the negative support group was more than that in the neutral support group, and the first time of weight-bearing was longer than that in the neutral support group, the difference was statistically significant(P＜0.05). The Harris scores of negative support group and neutral support group were lower than that of positive support group at 3 and 6 months after operation, and the Harris scores of negative support group were lower than that of neutral support group at 3 and 6 months after operation, the difference was statistically significant(P＜0.05).
〖WTHZ〗Conclusion〖HTSS〗Different anterior medial cortical support reduction combined with INTERTAN fixation, the positive and neutral support groups are much better than the negative support group, which can make full contact between the two ends of the fracture, improve the stability of the postoperative fracture, restore the line of force, reduce postoperative complications.

Key words: intertrochanteric fracture, restoration;positive support, INTERTAN, effect

刘殿奎1，马文海2*，张谦2，李永旺2，聂广龙1. 前内侧皮质不同复位类型联合INTERTAN固定治疗股骨粗隆间骨折的疗效分析[J]. 河北医科大学学报, doi: 10.3969/j.issn.1007-3205.2020.05.013.

LIU Dian-kui1, MA Wen-hai2*, ZHANG Qian2, LI Yong-wang2, NIE Guang-long1. Therapeutic effect of different medial reduction types of anterior medial cortex combined with INTERTAN fixation for intertrochanteric fractures[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.1007-3205.2020.05.013.

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前内侧皮质不同复位类型联合INTERTAN固定治疗股骨粗隆间骨折的疗效分析

Therapeutic effect of different medial reduction types of anterior medial cortex combined with INTERTAN fixation for intertrochanteric fractures

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