微创三平面复位在股骨粗隆间骨折闭合复位中的应用

Application of minimally invasive three graphic reduction method in treatment of femoral intertrochanteric fractures

目的探讨微创三平面复位法在股骨粗隆间骨折闭合复位中的应用。方法回顾性分析自2011-01—2013-12采用股骨近端防旋髓内钉（PFNA）内固定治疗的28例股骨粗隆间骨折,均通过手法及牵引复位后不能达到解剖复位,采用器械辅助微创三平面复位。结果本组手术时间45～85 min,平均55 min;术中出血量35～140 ml,平均75 ml。术中无血管及神经损伤。切口及穿刺针眼均愈合良好,无感染。复位情况按照Baumgaertner等的标准评定：优23例,可5例。结论器械辅助微创三平面复位能够使股骨粗隆间骨折达到良好的闭合解剖复位。

Objective To explore the clinical effect of minimally invasive three graphic reduction method in treatment of femoral intertrochanteric fractures. Methods Twenty eight cases of proximal femoral nail anti-rotation（PFNA） internal fixation for the treatment of femoral intertrochanteric fractures admitted to our hospital from January 2011 to December 2013 were retrospectively analyzed, which were still difficult to reach anatomical reduction after reconstructive traction. This group of patients received closed reduction with minimally invasive three graphic reduction method under instrument assistance.Results In this group, operation time was 45-85 min,average 55 min; bleeding in operation was 35-140 ml, average 75 ml.No neurovascular injury occurred during operation. The incisions and the puncture points of all patients were healed with no infection. According to the standard of Baumgaertner, 23 cases were excellent and 5 were good. Conclusion Instrument assistance with minimally invasive three graphic reduction method is an ideal treatment for femoral intertrochanteric fractures to reach closed anatomical reduction.