U-Blade钉通道下植骨在股骨转子间内侧壁骨折Gamma 3型髓内钉内固定中的应用效果

Effect of U-Blade nail channel bone graft applied to internal fixation with Gamma 3 intramedullary nail for medial intertrochanteric fracture of femur

目的探讨U-Blade钉通道下植骨在股骨转子间内侧壁骨折Gamma 3型髓内钉内固定中的应用效果。方法将67例股骨转子间骨折患者分为植骨组31例与对照组36例,两组患者均行闭合复位Gamma 3型髓内钉内固定术,术中仅植骨组患者经U-Blade钉通道植入人工骨。比较两组患者的手术时间、术中出血量、术后完全负重时间、颈干角丢失角度、骨折愈合时间及Harris髋关节评分。结果两组患者手术时间、术中出血量及术后1年Harris髋关节评分比较,差异均无统计学意义(均P>0.05);植骨组颈干角丢失角度、骨折愈合时间及完全负重时间均小于或短于对照组(均P<0.05)。术后两组患者均无切口感染,骨折均愈合,无明显螺钉切出,植骨组患者无同种异体骨排异反应。结论在股骨转子间骨折复位髓内钉内固定术中采用U-Blade钉通道下植骨,操作简便、安全有效,可缩短患者术后骨折愈合时间,提高内侧支撑能力。

Objective To investigate the effect of U-Blade nail channel bone graft applied to internal fixation with Gamma 3 type intramedullary nail for medial intertrochanteric fracture of femur. Methods Sixty-seven patients with intertrochanteric fracture of femur were divided into bone graft group（ 31 cases） and control group（ 36 cases）. All patients underwent closed reduction and internal fixation with Gamma 3 intramedullary nail. And the patients in the bone graft group received the artificial bone graft via U-Blade nail channel during operation. The operation duration,intraoperative blood loss,postoperative full weight-bearing time,neck-shaft angle loss,fracture healing time and Harris hip score were compared between the two groups. Results There was no significant difference between the two groups in the operation duration,intraoperative blood loss or postoperative 1-year hip Harris score（ all P〉 0. 05）. The neck-shaft angle loss,fracture healing time and full weight-bearing time in the bone graft group were smaller or less than those in the control group（ all P〈 0. 05）. After operation,fracture healing was observed in all patients of the two groups,without incision infection or obvious screw cut out,and no allograft rejection was seen in the bone graft group. Conclusion For the intertrochanteric fracture of femur,U-Blade nail channel bone graft applied to internal fixation with reduction of intramedullary nailing is safe,effective and easy-operated,which can decrease the postoperative fracture healing time and improve the medial bearing performance.