仰卧“剪刀”体位与单腿截石位结合防旋髓内钉治疗股骨粗隆骨折的临床对比

Clinical study on supine “scissors” position or half lithotomy position combined with proximal femoral nail anti-rotation in treatment of intertrochanteric femoral fracture

目的对比仰卧"剪刀"体位与单腿截石位结合防旋髓内钉(PFNA)治疗股骨粗隆骨折的临床效果。方法回顾分析2016年4月—10月我院骨外科收治的60例股骨粗隆骨折患者的临床资料,均行PFNA内固定治疗,根据患者体位不同分为仰卧单腿截石位组(对照组)与仰卧"剪刀"体位组(观察组),各30例。比较2组临床相关指标及并发症情况。结果观察组切口长度、骨折愈合时间及术后髋关节评分系统(Harris)评分与对照组比较,差异均无统计学意义(P>0.05);观察组手术时间、术中出血量及术中透视次数均明显少于对照组,差异有统计学意义(P<0.05);观察组并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论在PFNA治疗中取仰卧"剪刀"体位和单腿结石位均有助于股骨粗隆骨折患者关节功能恢复,但仰卧"剪刀"位可有效减少术中出血量及术中透视次数,缩短手术时间,提高手术安全性。

Objective To investigate the clinical effects of supine ＂scissors＂position or half lithotomy position combined with proximal femoral nail anti-rotation（PFNA）in treatment of intertrochanteric femoral fracture.Methods The clinical data of 60 patients with intertrochanteric femoral fracture in the department of orthopedics from 2016 April to October were retrospectively analyzed,and all of them were treated with PFNA internal fixation. All the patients were divided into supine half lithotomy position group（control group）and supine ＂scissors＂position group（observation group）by different positions,30 cases in each group.The clinical indexes and complications were compared between the two groups.Results There was no statistical difference in the length of incision,fracture healing time,postoperative hip joint score（Harris score） between the two groups（P〈0.05）;The operation time,intraoperative bleeding volume,intraoperative fluoroscopy times in observation group were less than those in control group（P〈0.05）;The incidence of complications in observation group was lower than control group（P〈0.05）.Conclusion Supine＂scissors＂position or half lithotomy position in PFNA can promote recovery of joint function. But supine ＂scissors＂position can effectively reduce intraoperative bleeding volume and fluoroscopy times,shorten operation time,increase surgical safety.