经皮微创植骨结合髓内钉内固定治疗股骨粗隆下骨折的临床疗效

Clinical efficacy of bone grafting through percutaneous catheter combined with intramedullary nail fixation in the treatment of subtrochanteric fracture

目的探讨经皮植骨结合髓内钉内固定治疗股骨粗隆下骨折的可行性和有效性。方法 44例股骨粗隆下粉碎性骨折患者随机均分为经皮植骨内固定组(A组)和传统切开复位内固定组(B组),比较两组术后治疗效果。结果术后随访12~18个月,影像学复查显示,内固定位置满意,骨折端正常愈合。与B组相比,A组手术时间、植骨时间、切口长度、出血量、骨折愈合时间均减少,髋关节Harris评分和总优良率增加(P<0.05)。结论经皮植骨结合髓内钉内固定治疗股骨粗隆下骨折具有创伤小、出血少、愈合快和恢复好等优势。

Objective To investigate the feasibility and effectiveness of bone grafting through percutaneous catheter combined with intramedullary nail fixation in the treatment of subtrochanteric fracture.Methods A total of 44 patients with subtrochanteric fracture was equally randomized into two groups of A（treated with bone grafting through percutaneous catheter and internal fixation）and B（treated with traditional open reduction and internal fixation）.The clinical outcomes after operation were compared between two groups.Results The patients were followed up by X-ray films for 12-18 months,which showed that internal fixation and fracture healing were all satisfactory.Compared with group B,the operation time,time of bone grafting,length of urgical incision,blood loss and healing time of fracture were decreased,while hip Harris score and total excellent rate were increased in group A（P〈0.05）.Conculsion The bone grafting through percutaneous catheter combined with intramedullary nail fixation in the threatment of subtrochanteric fracture has the advantages of smaller trauma,less blood loss,quicker healing and better recovery.