股骨近端骨折术后髓内钉周围再骨折的分型与治疗效果

Classification and therapeutic effect of refracture around the intramedullary nail after proximal femoral fracture surgery

目的:探讨股骨近端骨折术后髓内钉周围再骨折的分型与治疗效果。方法:收治股骨近端骨折术后髓内钉周围再骨折患者72例,以VAnCouver分型为依据将其分为A组(15例)、B组(20例)、C组(17例)、D组(20例)。A组进行保守治疗,B组、C组均进行锁定加压接骨板或者肱骨远端微创内固定治疗,D组使用动力髋螺钉固定肱骨骨折方式治疗。结果:A、B、C 3组患者恢复率与D组比较差异有统计学意义(P=0.048 9,P<0.05)。4组患者术后并发症率比较差异有统计学意义(P<0.05)。结论:对股骨近端骨折术后髓内钉周围再骨折患者进行分型治疗,效果显著。

Objective：To explore the classification and therapeutic effect of refracture around the intramedullary nail after proximal femoral fracture surgery.Methods：72 cases of the intramedullary nailing of the proximal femoral fracture were treated with VAnCouver classification,which were divided into the A group（15 cases）,the B group（20 cases）,the C group（17 cases）,and the D group（20 cases）.The A group was treated conservatively,both the B and the C group were treated with locking compression plate or distal end of humerus with minimally invasive internal fixation.The D group was treated with dynamic hip screw fixation for humeral fracture.Results：The recovery rates in the A,B and C group were significantly different compared with the D group（P=0.048 9）.There was a significant difference in postoperative complication rate between the four groups（P〈0.05）.Conclusion：The treatment of fractures of proximal femoral fractures after operation is effective.