改良股骨近端锁定钢板内固定治疗股骨粗隆外侧壁不完整型骨折的临床研究

Clinical Efficacy of Modified Proximal Femoral Locking Plate Internal Fixation in Treatment of Patients with Incomplete Fracture of Lateral Wall of the Femoral Trochanter

目的分析改良股骨近端锁定钢板内固定治疗股骨粗隆外侧壁不完整型骨折的效果。方法选择2017年1月—2020年9月本院收治的80例股骨粗隆外侧壁不完整型骨折,根据治疗方式的不同分为研究组41例(行改良股骨近端锁定钢板内固定治疗)和对照组39例(行股骨近端防旋髓内钉内固定治疗)。比较2组手术相关指标(手术时间、术中出血量、术后48 h引流量、骨折愈合时间),术后1年骨折愈合情况、髋关节功能恢复情况及术后并发症发生情况。结果研究组手术时间长于对照组,术中出血量、术后48 h引流量、骨折总愈合率及髋关节功能恢复优良率高于对照组,骨折愈合时间短于对照组,术后并发症总发生率低于对照组(P<0.01,P<0.05)。结论改良股骨近端锁定钢板内固定治疗股骨粗隆外侧壁不完整型骨折效果佳,虽手术难度较大,术中出血量较多,但可明显促进患者骨折愈合及髋关节功能恢复,并降低术后并发症发生率。

Objective To analyze clinical efficacy of modified proximal femoral locking plate internal fixation in treatment of patients with incomplete fractures of lateral wall of the femoral trochanter.Methods A total of 80 patients with incomplete fracture of lateral wall of the femoral trochanter admitted between January 2017 and September 2020 were selected and divided into research group(treated with modified proximal femoral locking plate internal fixation,n=41)and control group(treated with proximal femoral anti-rotation intramedullary nail internal fixation,n=39).according to different therapeutic methods Related indexes of operation(operative duration,intraoperative bleeding volume,drainage volume after operation for 48 h,fracture healing time),as well as fracture healing and function recovery of hip joint after operation for 1 year,and incidence rate of postoperative complications were compared between two groups.Results Compared with those in control group,operative duration was significantly longer,and intraoperative bleeding volume,drainage volume after operation for 48 h,the total fracture healing rate and excellent and good rate of hip function recovery were significantly higher,while fracture healing time was significantly shorter,and the total incidence rate of postoperative complications was significantly lower in research group(P<0.01,P<0.05).Conclusion Modified proximal femoral locking plate internal fixation is effective in treatment of patients with incomplete fracture of lateral wall of the femoral trochanter.Although the operation is difficult,and the volume of intraoperative bleeding is large,it may significantly promote fracture healing and recovery of hip function,and reduce incidence rate of postoperative complications.