InterTAN钉结合3D打印治疗不稳定性股骨粗隆间骨折的临床疗效

The clinical study of InterTAN nail combined with 3D printing in treatment of unstable femoral intertrochanteric fracture

目的观察InterTAN钉结合3D打印技术治疗不稳定性股骨粗隆间骨折的临床疗效。方法回顾性分析2017年1月至2018年12月蚌埠医学院第二附属医院40例确诊为不稳定性股骨粗隆间骨折患者的临床资料,根据治疗方法的不同,分为A组与B组,每组20例。A组采用InterTAN钉结合3D打印治疗,B组采用股骨近端防旋髓内钉(PFNA)治疗。观察比较两组患者术中出血量、手术时间、术后下地时间、骨折愈合时间、术后相关并发症及术后第3天Harris评分的差异。结果两组患者手术时间、术中出血量及骨折愈合时间进行比较,差异无统计学意义(P>0.05);A组患者平均术后下地时间为(14.12±3.43)d, B组为(21.42±2.81) d,差异有统计学意义(P<0.05);A组患者术后相关并发症的发生率为5.00%,低于B组,差异有统计学意义(P<0.05);术后第3天,A组患者Harris评分为(89.08±5.37)分,高于B组,差异有统计学意义(P<0.05),两组患者术前与术后第3天Harris评分的差值进行比较,差异有统计学意义(P<0.05)。结论 InterTAN钉结合3D打印治疗不稳定性股骨粗隆间骨折,能够提供更好的稳定性,术后下地早、并发症少,可明显改善髋关节功能,其治疗效果优于PFNA的治疗效果,值得临床推广。

Objective To observe the clinical effect of InterTAN nail combined with 3D printing in the treatment of unstable femoral intertrochanteric fracture.Methods The clinical data of 40 patients diagnosed with unstable intertrochanteric fracture in the Second Affiliated Hospital of Bengbu Medical College from January 2017 to December 2018 were retrospectively analyzed.According to the different treatment methods,they were divided into group A and group B,with 20 cases in each group.Group A was treated with InterTAN nail combined with 3D printing,and group B with proximal femoral anti-rotation intramedullary nail(PFNA).The operation time,intraoperative blood loss,postoperative time to ground,fracture healing time,postoperative complications and Harris score were observed and compared between the two groups.Results There were no significant differences in operation time,intraoperative blood loss and fracture healing time between the two groups(P>0.05).The mean postoperative time to ground was(14.12±3.43)d in group A and(21.42±2.81)d in group B,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in group A was 5.00%,lower than that in group B,and the difference was statistically significant(P<0.05).In the last follow-up,the Harris score in group A was(89.08±5.37),higher than that of group B,and the difference was statistically significant(P<0.05).The difference in Harris score between the two groups before and three days after surgery was statistically significant(P<0.05).Conclusions InterTAN nail combined with 3D printing in the treatment of unstable intertrochanteric fracture can provide better stability,early postoperative landing,fewer complications,and it significantly improves hip function.The therapeutic effect of InterTAN nail is better than that of PFNA,which is worthy of clinical promotion.