附加前侧小切口在股骨粗隆间骨折四型中应用效果研究

Study on application effect of additional anterior small incision in type Ⅳ intertrochanteric fracture of femur

目的探讨股骨附加前侧小切口在股骨粗隆间骨折四型(EvansⅣ)中的应用效果。方法选择2018年4月至2020年2月青岛市海慈医院收治的100例股骨粗隆间骨折EvansⅣ型患者,随机分为观察组与对照组,每组各50例,观察组采用附加前侧小切口股骨近端螺旋刀片髓内钉(PFNa)治疗,对照组采用常规PFNa切开治疗。比较两组的手术指标、骨折愈合情况、髋关节恢复情况以及并发症情况。结果观察组的手术时间、术中出血量、骨折愈合时间均优于对照组(P<0.05)。观察组髋关节恢复优良率为90.00%,高于对照组的74.00%(P<0.05)。观察组并发症发生率(4.00%)显著低于对照组(16.00%),差异有统计学意义(P<0.05)。结论股骨粗隆间骨折EvansⅣ型患者采用附加前侧小切口PFNa治疗,术中出血量更少,手术时间和愈合时间更短,髋关节恢复情况好,并发症较少,更有利于患者术后恢复。

Objective To investigate the application effect of additional anterior small incision in typeⅣintertrochanteric fracture of femur(EvansⅣ).Methods A total of 100 patients with EvansⅣintertrochanteric fracture of femur who were admitted to Qingdao Haici Hospital from April 2018 to February 2020 were selected and randomly divided into the observation group(50 patients)and the control group(50 patients).The observation group was treated with proximal femoral nail antirotation(PFNa)with the additional anterior small incision,and the control group was treated with conventional PFNa incision.The surgical indicators,fracture healing,hip recovery and complications of the two groups were compared.Results The operative time,intraoperative blood loss and fracture healing time of the observation group were better than those of the control group(P<0.05).The excellent rate of hip joint recovery in the observation group was 90.00%,which was higher than that in the control group(74.00%)(P<0.05).The complication rate of the observation group(4.00%)was significantly lower than that of the control group(16.00%),the difference was statistically significant(P<0.05).Conclusion Patients with intertrochanteric fractures of the femur EvansⅣtreated with PFNa with the additional anterior small incision have less intraoperative blood loss,shorter operative and healing time,better hip recovery,fewer complications,and better postoperative recovery.