摘要
目的:比较中医正骨手法复位骨折后防旋型股骨近端髓内钉(Proximal femoral nail antirotation,PFNA)和动力髋螺钉(Dynamic hip screw,DHS)两种微创手术治疗股骨粗隆间骨折-逆粗隆型的临床效果,探讨该类型骨折正骨技术参与的必要性。方法:回顾性分析2014年1月-2016年1月本团队应用DHS治疗股骨粗隆间骨折-逆粗隆型的73例患者(DHS组)与应用PFNA治疗的84例患者(PFNA组)的临床资料。对比两组患者的手术时间、术中出血、术后自行坐床边开始时间、术后愈合时间、术后与否伴发内固定物周围骨折和顶尖切出导致固定失败、满意度。结果:两组患者均随访1年以上。PFNA组的手术时间、术中出血、患者自行坐床边起时间、骨折愈合时间、满意度均明显优于DHS组,差异均有统计学意义(P<0.05)。结论:中医正骨手法结合PFNA复位快、创伤小、出血少、术中骨折断端稳定、术后患者可早日完成床上生活自理、患者依从性好,有经验的医生可以应用正骨手法结合PFNA固定股骨粗隆间骨折-逆粗隆型。
Objective：To compare the clinical effect of internal fixation in the femoral intertrochanteric fractures with PFNA and DHS after bonesetting technology of TCM,to evaluate the reasonable way in treatment for the types.Method：Retrospective analysis,from January 2014 to January 2016,the team applied DHS to treat intertrochanteric fractures-trans trochanteric type in 73 patients（DHS group） and 84 patients treated with PFNA（PFNA group）.The operation time,blood loss,the beginning time of sitting and swinging by bed,the time of fracture healing,whether or not accompanied by secondary fracture around implant,satisfaction of the two groups were compared.Result：All the patients were followed up 12 months.The operation time,intraoperative bleeding,the patient＇s sitting time at the bedside,fracture healing time,satisfaction of PFNA group were significantly better than those in DHS group,the differences were statistically significant（P〈0.05）.Conclusion：TCM massage combined with PFNA,the patient is less time to bonesetting,less surgery trauma,less blood loss,maintainingfixation,rapid recovery in helping to live in bed,easy to accept,experienced doctors can use manipulation combined with PFNA fixation of intertrochanteric fracture of femur tuberositas-inverse type.
出处
《中国医学创新》
CAS
2017年第24期28-32,共5页
Medical Innovation of China
基金
北京市通州区科委2016年科技创新资金项目(KL2016CX057)
关键词
股骨转子间骨折-逆粗隆型
正骨技术
股骨近端髓内钉
动力髋螺钉
Femoral intertrochanteric fractures
Bonesetting technology
Proximal femoral nail antirotation
Dynamic hip screw
