Intertan治疗股骨转子间粉碎性骨折术后髋关节功能评价

Clinical hip joint function on f＇wafion of comminuted intertrochanteric fracture of femur with single Intertan

目的：观察单纯Intertan髓内钉治疗股骨转子间粉碎性骨折未行小转子处理术后髋关节功能变化。方法：2012年1月-2016年6月我科应用Intertan髓内钉治疗股骨转子间粉碎性骨折患者67例，无一行小转子固定，骨折AO／OTA分型，其中31-A2．1型17例，31-A2．2型19例，31-A2．3型17例，31-A3．3型14例。术后随访分别记录骨折愈合情况，术后并发症，患髋运动情况，采用Harris评分系统进行髋关节功能评价。结果：所有患者术后获12～24个月（平均17个月）随访。X线示骨折均愈合，平均愈合时间3．72±0．37个月。3例股骨头颈短缩，3例小转子移位，2例髋内翻，2例发生患侧肢体短缩，3例出现惠髋外展和屈曲受限，均为3l-A3．3患者。末次Harris评分：31-A2型平均评分为89．57±6．71分；31-A3．3型平均评分为61．16±13．58分。结论：Intertan髓内钉设计更加具备股骨近端生物力学特点，能够有效恢复股骨转子间骨折稳定性，是治疗31-A2型股骨转子间骨折的良好选择。

objective：To observe hip joint function of comminuted intertrochanteric fracture treated with Intertan intramedullary nail and lesser trochanteric fragment not to be fixed.Method：Between January 2012 and June 2016,67 patients with eomminnted intertrochan-terie femur fractures were enrolled in this study.Lesser trochanterie fragment of these patients weren＇ t fixed in the operation.All the frac-tures were classified according to the standard of OA/OTA.17 case of 31-A2.1 type,19 case of 31-A2.2,17 case of 31-A2.3 type,14 case of 31-A3.3 type.We recorded the bone healing,postoperative complication,and postoperative functional restoration at follow-up.Hip functional recovery was evaluated by the Harris hip score.Results：This series got an average follow-up of 17 months,range from 12 to 24 months.All patients got bone healing and the average bone union time was 3.72 ± 0.37 months.No patient of 31-A2 fractures appear various complications.Among the patients of 31-A3.3 fractures,femoral neck shortening occurred in 3 cases,displacement of lesser trochanteric fragment occurred in 3 cases,coxa vara occurred in 2 cases,limb shortening occurred in 2 cases ,hip activity disorder occurred in 3 cases.The mean Harris hip score were 89.57 ± 6.71 for 31-A2 pafiens and 61.16 ± 13.58 for 31-A3.3 patients.Conclusion：Intertan intramedullary nail device was consistent with proximal femur biomeehanical characteristics and can effectively restore stability of intertrochanterie fracture,the Intertan intramedullarv nail could be a good option to treat 31-A2 intertrochanteric fracture.