有限切开重建髓内钉联合术后早期康复锻炼治疗股骨粗隆下骨折

Limited Incision Joint Early Postoperative Rehabilitation Exercise Femoral Reconstruction Intramedullary Nail in the Treatment of Femoral Trochanter Fracture

目的:探讨重建髓内钉联合术后早期康复锻炼治疗股骨粗隆下骨折的临床疗效。方法:纳入患者13例,根据Seinsheimer分型:I型4例,IIA型2例,IIB型1例,IIC型2例,IIIA型1例,IIIB型2例,IV型1例。其中男9例,女4例:年龄17～67岁,平均38.3岁。全部患者均予以有限切开重建髓内钉内固定联合术后早期康复锻炼治疗。结果:13例患者获得随访4～24月(平均8个月),骨折临床愈合时间3～6.5月,平均愈合时间4.8月;无内固定物松动、断裂及畸形、关节感染、骨不连等发生,术后发生切口表浅感染2例,轻度髋内翻2例,肢体短缩1例,1例患者长距离行走后有疼痛感。按Harris评分法对髋关节功能进行评定:优9例,良2例,可2例,优良率为84.6%。结论:有限切开股骨重建髓内钉治疗股骨粗隆下骨折生物力学稳定,能有效恢复骨折的稳定性及完整性,联合术后早期康复锻炼,能促进骨折愈合。术后早期康复治疗必须在一定条件下进行。

Objective:To explore the reconstruction intramedullary nailing combined early postoperative rehabilita -tion exercise under the treatment of femoral trochanter fracture clinical curative effect .Methods:Included in 13 cases of pa-tients,according to Seinsheimer classification:4 cases were type I ,type type IIA in 2 cases,type IIB 1 case,IIC type in 2 ca-ses,IIIA type 1,type IIIB in 2 cases,type IV in 1 case.The male 9 cases,female 4 cases,aged 17~67 years old,average 38.3 years.All patients were cut shall be limited to joint reconstruction intramedullary nail fixation treatment of early post -operative rehabilitation exercise.Results:13 patients were followed up for 4~24 months (mean,8 months),fracture clinical healing time 3~6.5 months,the average healing time of 4.8 months; No looseness,breakage of internal fixation and de-formity,joint infection,bone nonunion,postoperative superficial incision infection occurred in 2 cases,2 cases were mild hip varus,limb shortening in 1 case,1 patients pain after a long walk .Of the hip joint function were assessed by Harris scoring method:9 cases,good in 2 cases,2 cases,fine rate was 84.6%.Conclusion:Limited incision under the femoral reconstruc-tion intramedullary nail in the treatment of femoral trochanter fracture biomechanical stability , can effectively restore the fracture stability and integrity ,joint early postoperative rehabilitation exercise ,can promote the fracture healing .Early post-operative rehabilitation treatment should be carried out under certain conditions .