新型下肢骨折牵引器在股骨转子间骨折闭合复位PFNA内固定术中的应用
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滨州医学院附属医院

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山东省医药卫生科技发展计划项目;山东省自然基金(联合项目)


A new tractor used in closed reduction and interal fixation with proximal femoral nail antirotation(PFNA)for femoral intertrochanteric fractures
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Affiliated Hospital to Binzhou Medical University

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Shandong Medical and Health Science and Technology Development Plan Project; Shandong Natural Fund (joint project)

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    摘要:

    [目的] 探讨骨牵引器辅助闭合复位PFNA内固定技术治疗股骨转子间骨折的临床效果及手术技巧。[方法] 回顾性分析2015年6月至2018年1月期间,骨牵引器辅助闭合复位PFNA内固定技术治疗的76例股骨转子间骨折患者资料。其中男29例,女47例,平均(69.55±5.12)岁。[结果] 76 例患者均成功闭合复位,体位摆放时间平均(8.06±1.41) min,透视次数平均(42.13±5.63)次,手术时间平均(50.04±5.86)min,术中出血量平均(192.34±35.63)ml。其中5例患者因死亡等原因未获得完整随访;2例患者防旋钉切出,行二次人工全髋关节置换术治疗。69例患者获得完整随访,随访时间12-18个月,平均(14.23±2.17)个月。患者12月内骨折全部愈合,愈合时间平均(11.77±3.17)周。末次随访时,根据Harris评分标准评价疗效:优15例,良47例,可7例,优良率为89.86%。

    Abstract:

    [Objective] To evaluate the clinical outcomes and surgical technique of skeletal tractor which is applied in close reduction and internal fixation with proximal femoral nail anti-rotation(PFNA)for femoral intertrochanteric fractures.[Methods] From june 2015 to January 2018,76 patients with femoral intertrochanteric fractures were treated by closed reduction and interal fixation with proximal femoral nail anti-rotation(PFNA) in which skeletal tractor was used.There were 29 men and 47 women,with an average age of (69.55±5.12) years.[Results] All 76 patients were successfully closed reduction.The time for patient positioning was averaged(8.06±1.41)minutes,the number of fluoroscopy during operation average( 42.13±5.63),the average time of operation was (50.04±5.86)minutes,and the average amount of bleeding during operation was (192.34±35.63) ml. Five patients were not followed up completely because of death and other reasons.Two patients underwent second total hip arthroplasty after anti-rotation screw cut out from femoral head. 69 patients were followed up for 12 to 18 months,with an average of (14.23 ±2.17) months. All fractures healed within 12 months,with an average healing time of (11.77 ±3.17) weeks. At the last follow-up,according to Harris scoring criteria,the function of the affected hip effect was evaluated: excellent in 15 cases, good in 47 cases,fair in 7 cases,the excellent and good rate was 89.86%.[Conclusion] Skeletal tractor assisted closed reduction and PFNA internal fixation for the treatment of intertrochanteric fracture of femur does not require open reduction, has short patient positioning time,fewer fluoroscopy times, and satisfactory clinical results.

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  • 收稿日期:2019-08-21
  • 最后修改日期:2019-09-26
  • 录用日期:2019-10-08
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