经皮撬拨技术治疗粗隆间难复性骨折的效果及安全性研究

doi:10.3969/j.issn.1007-3205.2021.02.005

河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (2): 145-149,153.doi: 10.3969/j.issn.1007-3205.2021.02.005

经皮撬拨技术治疗粗隆间难复性骨折的效果及安全性研究

1.河北省张家口市第一医院骨一科，河北张家口 075000；2.张家口学院护理学院，河北张家口 075000

出版日期:2021-02-25 发布日期:2021-03-09
作者简介:王建华（1981-），男，河北抚宁人，河北省张家口市第一医院副主任医师，医学硕士，从事骨外科疾病诊治研究。
基金资助:
河北省医学科学研究重点课题计划（20160248）

Effect and safety of percutaneous prying technique in the treatment of refractory intertrochanteric fracture

1.Department of Orthopedics, the First Hospital of Zhangjiakou City, Hebei Province，
Zhangjiakou 075000, China; 2.School of Nursing, Zhangjiakou University,
Hebei Province， Zhangjiakou 075000, China

Online:2021-02-25 Published:2021-03-09

摘要/Abstract

摘要： 目的探讨经皮撬拨技术治疗粗隆间难复性骨折患者的临床效果和安全性。
方法回顾性分析股骨粗隆间难复性骨折患者90例，根据不同手术方式分为对照组与观察组，每组45例。对照组接受切开复位髓外固定术治疗，观察组接受经皮撬拨闭合复位髓内固定术治疗。比较2组术中情况（切口长度、手术时间、术中出血量），手术恢复情况（住院、负重、骨折愈合时间），股骨颈干角、股骨颈长度、视觉模拟评分法(visual analogue scale，VAS)评分、Harris评分优良率和并发症发生情况。
结果观察组手术切口长度、手术时间、术中出血量、术后住院时间、负重时间、骨折愈合时间均明显短于或少于对照组（P＜0.05）；术后即刻、术后6个月2组间和组内股骨颈干角、股骨颈长度差异均无统计学意义（P＞0.05）。术后7 d，2组VAS评分显著低于术前（P＜0.05）；2组间术前、术后7 d同时间点VAS评分差异无统计学意义（P＞0.05）。观察组Harris评分优良率明显高于对照组（P＜0.05）；2组患者并发症发生率差异无统计学意义（P＞0.05）。
结论经皮撬拨闭合复位髓内固定术治疗股骨粗隆间难复性骨折在促进术后骨折愈合、改善远期疼痛、髋关节功能等方面效果显著，安全性较高，可在广大基层医院推广应用。

关键词: 股骨骨折, 经皮撬拨技术, 闭合复位

Abstract: Objective To investigate the clinical effect and safety of percutaneous prying technique in the treatment of refractory intertrochanteric fractures.
Methods Clinical data of 90 patients with refractory femoral intertrochanteric fracture were retrospectively analyzed. They were divided into control group(n=45)and observation group(n=45) according to different operation methods. The control group received open reduction and extramedullary fixation, and the observation group received percutaneous prying closed reduction and intramedullary fixation. The intraoperative conditions(incision length, duration of operation, intraoperative blood loss), operation recovery(length of hospitalization, weight-bearing time, fracture healing time), femoral neck shaft angle, femoral neck length, visual analogue scale(VAS) score, excellent and good rate according to Harris score and complications were compared between two groups.
Results The incision length, duration of operation, intraoperative blood loss, postoperative hospital stay, weight-bearing time and fracture healing time of the observation group were significantly shorter or less than those of the control group(P＜0.05). There were no significant differences in femoral neck shaft angle and femoral neck length between two groups immediately after operation, at 6 months after operation and before and after treatment(P＞0.05). The VAS score of the two groups was significantly lower than that before operation at 7 d after operation(P＜0.05), and there was no significant difference in VAS score between two groups at the same time point before operation and at 7 d after operation(P＞0.05). The excellent and good rate of Harris score in the observation group was significantly higher than that in the control group(P＜0.05), but there was no significant difference in the incidence of complications between two groups(P＞0.05).
Conclusion Percutaneous prying closed reduction and intramedullary fixation in the treatment of femoral intertrochanteric fracture is effective and safe in promoting fracture healing, improving long-term pain and hip joint function, which, therefore, can be widely used in primary hospitals.

Key words: emoral fractures, percutaneous prying technique, closed reduction

王建华, 林艳, 吴永东, 王有宝. 经皮撬拨技术治疗粗隆间难复性骨折的效果及安全性研究[J]. 河北医科大学学报, 2021, 42(2): 145-149,153.

WANG Jian-hua, LIN Yan, WU Yong-dong, WANG You-bao. Effect and safety of percutaneous prying technique in the treatment of refractory intertrochanteric fracture[J]. Journal of Hebei Medical University, 2021, 42(2): 145-149,153.

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经皮撬拨技术治疗粗隆间难复性骨折的效果及安全性研究

Effect and safety of percutaneous prying technique in the treatment of refractory intertrochanteric fracture

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