G形臂X线机辅助股骨粗隆间骨折PFNA置入的应用价值

The application value of G-arm X-ray machine assisted PFNA placement in the femoral intertrochanteric fracture

目的探讨G形臂X线机辅助置钉在股骨粗隆间骨折股骨近端防旋髓内钉(PFNA)内固定术中的应用价值。方法回顾性分析延安大学附属医院2016年2月～2017年8月采用PFNA内固定治疗的75例股骨粗隆间骨折,39例术中应用G形臂X线机辅助置钉(记为G形臂组),36例术中应用C形臂X线机辅助置钉(记为C形臂组)。比较两组手术时间、术中出血量、术中透视次数,末次随访髋关节功能Harris评分。结果 G形臂组解剖复位35例,功能复位4例;C形臂组解剖复位31例,功能复位5例,两组比较差异无统计学意义(P> 0.05)。两组均获得5～8个月随访。G形臂组手术时间、术中出血量、术中透视次数少于C形臂组,差异有统计学意义(P <0.05)。两组末次随访髋关节功能Harris评分比较,差异无统计学意义(P> 0.05)。结论股骨粗隆间骨折PFNA内固定术中采用G形臂X线机辅助置钉可减少手术时间、术中出血量及术中透视次数,可获得良好的临床疗效。

Objective To explore the application value of G-arm X-ray machine assisted nailing in proximal femoral nail anti-rotation(PFNA) placement in the femoral intertrochanteric fracture. Methods Seventy-five cases of femoral intertrochanteric fractures in Yan’an University Affiliated Hospital treated by PFNA from February 2016 to August2017 were retrospectively analyzed. Thirty-nine cases were received intraoperative G-arm X-ray machine assisted nailing(regarded as G-arm group), while 36 cases were received intraoperative C-arm X-ray machine assisted nailing(regarded as C-arm group). The operative time, intraoperative blood loss, intraoperative fluoroscopy times and Harris score of the hip joint function at the last follow-up were compared between the two groups. Results In the G-arm group, 35 cases were anatomically repositioned and 4 cases were functionally repositioned, while in the C-arm group, 31 cases were anatomically repositioned and 5 cases were functionally repositioned, there was no statistically significant difference between the two groups(P > 0.05). The follow-up was 5-8 months in the two groups. The operative time, intraoperative blood loss, and intraoperative fluoroscopy times of the G-arm group were less than those of the C-arm group,and the differences were statistically significant(P < 0.05). There was no significant difference in the Harris scores between the two groups at the last follow-up(P > 0.05). Conclusion The use of G-arm X-ray machine assisted nailing in PFNA of femoral intertrochanteric fracture can reduce the operation time, intraoperative blood loss and intraoperative fluoroscopy times, and obtain good clinical efficacy.