牵引器联合PFBN仿生髓内钉治疗股骨转子间骨折短期疗效观察

Short term effect of retractor combined with PFBN biomimetic intramedullary nail in the treatment of intertrochanteric fracture of femur

目的观察牵引器联合PFBN仿生髓内钉治疗股骨转子间骨折短期疗效。方法回顾性分析36例髓内钉内固定治疗股骨转子间骨折病例。术中应用牵引床联合interTAN(加压交锁髓内钉系统)牵引复位固定的患者为牵引床interTAN组(18例);术中应用骨折牵引器联合PFBN(股骨近端仿生髓内钉系统)牵引复位固定的患者为牵引器PFBN组(18例)。比较两组术中准备时间、复位时间、手术时间、透视时间、术后骨折愈合时间和髋关节功能Harris评分。结果两组平均随访时间5个月。牵引器PFBN组术中准备时间(18.1±1.5)min、复位时间(7.1±1.9)min、透视时间(3.3±0.6)min低于牵引床interTAN组术中准备时间(29.1±2.5)min、复位时间(10.1±2.2)min、透视时间(3.8±0.8)min,差异有统计学意义(t=16.007,P<0.001;t=4.379,P<0.001;t=2.235,P<0.05)。两组术后骨折愈合时间和髋关节功能Harris评分差异无统计学意义(t=2.126,P>0.05;t=2.601,P>0.05)。牵引床interTAN组出现会阴挤压伤1例,头颈螺钉切割固定失效1例。结论牵引器联合PFBN仿生髓内钉治疗股骨转子间骨折复位成功率高,并发症少,能缩短复位时间,可以提供坚强固定,有效避免髋内翻畸形,头颈螺钉切出。

Objective To observe and compare the short-term effect of traction device combined with PFBN biomimetic intramedullary nail in the treatment of femoral intertrochanteric fracture.Methods 36 cases of intertrochanteric fracture of femur treated by internal fixation with intramedullary nail were analyzed retrospectively.During the operation,surgical traction bed combined with InterTAN(compression interlocking intramedullary nail),and fracture retractor combined with PFBN bionic intramedullary nail were applied for traction reduction and fixation.They were divided into traction bed InterTAN group(18 cases)and retractor PFBN group(18 cases).The preparation time,operation time,reduction time,radiation time,postoperative fracture healing time and Harris score of hip function were compared between the two groups.Results The average follow-up time of the two groups was 5 months.The preparation time,operation time,reduction time and radiation time in the retractor PFBN group were lower than those in the traction bed InterTAN group,and the difference was statistically significant.There was one case of perineum crush injury and one case of head and neck screw cutting and fixation failure in the traction bed InterTAN group.Conclusion Retractor combined with PFBN biomimetic intramedullary nail in the treatment of femoral intertrochanteric fracture has a high success rate of reduction and fewer complications,which can shorten the time of reduction,provide strong fixation,and effectively avoid coxa vara deformity and head and neck screw cutting out.