术前测定健侧NSA对股骨粗隆间骨折术后髋内翻的影响

The Effect of the Measurement of Contralateral NSA on Coxa Varus After Intertrochanteric Fracture Before Operation

目的探讨股骨粗隆间骨折术前测定健侧股骨颈干角(Neck Shaft Angle,NSA)对术后髋内翻的影响。方法按标准纳入2016年1月—2017年5月收治的股骨粗隆间骨折内固定手术患者115例,其中A组40例术前测定健侧NSA,术中参考健侧NSA进行复位固定,而B组75例术前未测定健侧NSA,两组均采取PFNA固定,记录双侧NSA。记录双侧NSA的差值,△NSA=健侧NSA-患侧NSA。结果 A组中仅有1例患者△NSA≥10°(1/40),而B组中有14例患者△NSA≥10°(14/75),两者差异存在统计学意义(P=0.018)。结论股骨粗隆间骨折术前测定健侧NSA可以减少术后髋内翻。

Objective To investigate the effect of neck shaft angle （NSA） on the coxa varus in the patients with intertrochanteric fracture before operation. Methods According to the standard, 115 cases of intertrochanteric fracture were treated by internal fixation from January 2016 to May 2017, 40 cases in the A group was preoperative determined the contralateral side NSA, the contralateral lateral NSA was fxed and fxed during the operation, 75 cases in the B group were not measured NSA in the contralateral side before operation, PFNA fxation was performed in the two groups, bilateral NSA was recorded. The difference of bilateral NSA was recorded, △ NSA=normal NSA–injured NSA. Results Only one case of patient in the A group got △NSA≥10° （1/40）, whereas 14 patients in the B group got △ NSA ≥ 10° （14/75）. Chi-square test showed a lower postoperative coxa vara rate of preoperative measurement of the normal- side NSA compared with preoperative non-measurement of the normal- side NSA for femoral intertrochanteric fracture （P=0.018）. Conclusion Preoperative measurement of the normal- side NSA is able to reduce postoperative coxa vara. It is a reliable and easy method for extensive application without additionally economic costs.