牵引床两种体位股骨近端防旋髓内钉治疗股骨转子间骨折的疗效比较

The efficacy comparison of proximal femoral nail antirotation for femoral intertrochanteric fracture in two kinds of body postions on the traction bed

目的比较牵引床仰卧位和侧卧位股骨近端防旋髓内钉(PFNA)治疗股骨转子间骨折的疗效。方法将31例股骨转子间骨折患者根据手术体位不同分为仰卧位组(15例,采用牵引床仰卧位PFNA治疗)和侧卧位组(16例,采用牵引床侧卧位PFNA治疗)。比较两组手术情况,末次随访时采用Harris评分评价髋关节功能。结果患者均获得随访,时间6~18个月。切口长度、手术时间、术中出血量、术中透视次数侧卧位组均短(少)于仰卧位组,两组比较差异均有统计学意义(P<0.05);住院时间、骨折愈合时间两组比较差异均无统计学意义(P>0.05)。末次随访时髋关节功能Harris评分优良率两组比较差异无统计学意义(P>0.05)。结论相较于仰卧位,牵引床侧卧位PFNA治疗股骨转子间骨折具有创伤小、术中出血量少、手术时间短、操作简单等优点。

Objective To compare the clinical effect of proximal femoral nail antirotation(PFNA)for treatment of femoral intertrochanteric fracture in the lateral decubitus position and the supine position on the traction bed.Methods The 31 patients of femoral intertrochanteric fractures were treated with PFNA using traction bed;they were divided into two groups according to different body postions,15 cases were adopted with the supine position,and 16 cases were performed with the lateral decubitus position.The surgery situation was compared between two groups.At the last follow-up,the hip function was assessed with Harris score criterion.Results All cases were followed up for 6~18 months.The incision length,operative time,intraoperative blood loss,and intraoperative fluoroscopy times in the lateral decubitus position were shorter(less)than those of the supine position,the differences were statistically significant between two groups(P<0.05).Two groups had no differences in the hospitalization time and fracture healing time(P>0.05).At the last follow-up,there was no difference in the excellent-good rate of Harris score of the hip function(P>0.05).Conclusions In the treatment of femoral intertrochanteric fracture,compared with supine position,using PFNA in the lateral decubitus position on the traction bed has the advantages of less trauma,less intraoperative bleeding volume,shorter operation time,simple surgery procedure.