Cable环扎联合髓内针固定治疗老年股骨转子间骨折的效果

Effect of Cable cerclage combined with intramedullary nailing fixation in elderly femoral intertrochanteric fractures

目的探讨Cable环扎联合髓内针在老年股骨转子间骨折中的临床应用价值。方法选取2015年5月～2017年12月我院收治的90例股骨转子下骨折患者作为研究对象,按照随机数字表法分为两组,每组各45例。观察组患者行Cable环扎联合髓内针固定,对照组患者行单纯髓内针固定。比较两组患者的手术时间、术中出血量、术后留置引流时间。术后3个月随访,比较两组的步行速度与坐立耗时。比较两组患者手术前及术后3个月的Harris髋关节功能评分及两组患者的功能恢复情况。结果观察组患者的手术时间与术后留置引流时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组患者的10 m步行耗时、连续5次坐立体位改变耗时均短于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组患者的Harris髋关节功能评分显著高于术前及对照组,差异有统计学意义(P<0.05)。观察组患者的术后出院时间、康复期间拄拐下地行走时间及弃拐独立行走时间均早于对照组,差异有统计学意义(P<0.05)。结论针对老年股骨转子间骨折患者,使用Cable环扎技术联合髓内钉内固定,相对于单纯髓内钉固定,其手术时间更短,术后运动功能恢复理想。

Objective To evaluate the clinical value of Cable cerclage combined with intramedullary nailing fixation inelderly femoral intertrochanteric fractures. Methods A total of 45 patients with femoral subfamoral fractures admitted inour hospital from May 2015 to December 2017 were selected as subjects and were divided into two groups according tothe random number method, 45 cases in each group. Patients in the observation group were treated with Cable cerclagecombined with intramedullary nailing fixation. Patients in the control group were treated with simple intramedullary pinfixation. The operation time, intraoperative blood loss and postoperative drainage time between two groups were compared. Postoperative follow-up was 3 months, the walking speed and sitting time of the two groups were compared. TheHarris hip function score before and 3 months after surgery were compared between the two groups, and the functionalrecovery of the two groups were also compared between the two groups. Results The operation time and postoperativedrainage time in the observation group were shorter than those in the control group, the intraoperative blood loss in theobservation group was less than that in the control group, the differences were statistically significant （P〈0.05）. In theobservation group, the time spent on walking 10 meters and the time spent on 5 consecutive sitting and stereoscopicposition changes in the observation group were shorter than those in the control group, the differences were statistically significant （P〈0.05）. Three months after surgery, the Harris hip function scores in the observation group were significantly higher than that before surgery and the control group, the differences were statistically significant （P〈0.05）. Thepostoperative discharge time, the time of walking and walking under the abduction, and the time of independent walking after abandonment in the observation group were earlier than those in the control group, the differences were statistically significant （P〈0.05）. Conclusion In the elderly patients with intertrochanteric fractures, the use of Cable cerclage combined with intramedullary nailing fixation, relative to intramedullary nail fixation, operation time is short,postoperative motor function recovery ideal.