顶棒支撑法复位结合髓内钉固定治疗难复性股骨转子间骨折的效果

Effect of Top Rod Support Reduction Combined with Intramedullary Nail Fixation in the Treatment of Refractory Intertrochanteric Fracture of the Femur

目的:探讨顶棒支撑法复位结合髓内钉固定治疗难复性股骨转子间骨折的效果。方法:将福建省级机关医院2018年10月-2021年10月收治的61例难复性股骨转子间骨折患者按照随机数字表法分为观察组和对照组,对照组30例予以切开或有限切开复位结合髓内钉固定治疗,观察组31例予以顶棒支撑法复位结合髓内钉固定治疗,观察两组手术和恢复情况、骨折复位质量、髋关节功能及并发症发生率。结果:观察组手术时间、骨折复位时间、住院时间、骨折愈合时间均短于对照组,手术出血量少于对照组(P<0.05);观察组复位满意率(100%)高于对照组(80.00%)(P<0.05);观察组疼痛、功能、畸形、活动范围评分及总分均高于对照组(P<0.05);观察组并发症总发生率(9.68%)低于对照组(30.00%)(P<0.05)。结论:顶棒支撑法复位结合髓内钉固定治疗难复性股骨转子间骨折有助于缩短骨折复位时间和手术时间,减少手术出血量,提高复位满意率,促进骨折愈合和髋关节功能恢复,减少术后并发症发生。

Objective:To explore the effect of top rod support reduction combined with intramedullary nail fixation in the treatment of refractory intertrochanteric fracture of the femur.Method:A total of 61 patients with refractory intertrochanteric fracture of the femur treated in Fujian Provincial Government Hospital from October 2018 to October 2021 were divided into observation group and control group according to the random number table method.A total of 30 cases in the control group were treated with incision or limited incision reduction combined with intramedullary nail fixation,while 31 cases in the observation group were treated with top rod support reduction combined with intramedullary nail fixation.The operation and recovery,fracture reduction quality,hip function and complication rate of the two groups were observed.Result:The operation time,fracture reduction time,hospitalization time and fracture healing time in the observation group were shorter than those in the control group,and the amount of operation bleeding was less than that in the control group (P<0.05).The satisfactory rate of reduction in the observation group (100%) was higher than that in the control group (80.00%) (P<0.05).The scores of pain,function,deformity,range of activity and total score in the observation group were higher than those in the control group (P<0.05).The total incidence of complications in the observation group (9.68%) was lower than that in the control group (30.00%) (P<0.05).Conclusion:Treatment of refractory intertrochanteric fracture of the femur with top rod support reduction combined with intramedullary nail fixation is helpful to shorten the reduction time and operation time,reduce amount of operation bleeding,improve the reduction satisfaction rate,promote fracture healing and hip joint function recovery,and reduce postoperative complications.