简易型髓内钉进针点定位器在髓内钉固定术中的应用

The application of simple intramedullary nail entry point locator in the intramedullary fixation

目的探讨简易型髓内钉进针点定位器在髓内钉固定术中的应用效果。方法将行髓内钉固定治疗的206例股骨转子间骨折患者根据随机数字表法分为A组(术中采用简易型髓内钉进针点定位器定位进针点)与B组(术中采用常规方法定位进针点),各103例。比较两组手术情况、术后功能锻炼以及骨折愈合情况。术后4个月采用髋关节Harris评分评价髋关节功能恢复情况。结果患者均获得随访,时间12~18(15.11±2.27)个月。手术准备时间A组长于B组(P<0.05);手术时间、手术总时间、透视次数、术中出血量、切口长度A组均短(少)于B组(P<0.05)。两组开始扶拐不负重时间、开始部分负重时间、骨痂形成时间、骨折愈合时间比较差异均无统计学意义(P>0.05)。术后4个月Harris评分两组比较差异无统计学意义(P>0.05)。结论髓内钉固定治疗股骨转子间骨折患者术中使用简易型髓内钉进针点定位器能缩短手术时间,减少手术创伤,有效解决髓内钉固定术中进针点定位困难的问题,疗效满意。

Objective To investigate the application effect of simple intramedullary nail entry point locator in intramedullary fixation.Methods A total of 206 patients with femoral intertrochanteric fractures who were treated with intramedullary nail fixation were divided into group A(used simple intramedullary nail entry point locator during surgery)and group B(used conventional method to locate the entry point during surgery),according to random number table method,with 103 cases in each group.Operation condition,postoperative functional exercise and fracture healing were compared between the two groups.The functional recovery of hip joint was evaluated by Harris score at 4 months after surgery.Results All patients were followed up for 12~18(15.11±2.27)months.Operation preparation time of group A was longer than group B(P<0.05);group A was shorter(less)than group B in the operation time,total operation time,fluoroscopy times,intraoperative blood loss and incision length(P<0.05).There were no statistical differences in the start time of crutching without weight-bearing,start time of partial weight-bearing,callus formation time and fracture healing time between the two groups(P>0.05).At 4 months after surgery,there was no statistical difference in Harris score between the two groups(P>0.05).Conclusions In the treatment of femroral intertrochanteric fracture,the use of simple intramedullary nail entry point locator can shorten the operation time,decrease the surgical injury,effectively solve the question of entry point location difficulty during the intramedullary nail fixation operation,with satisfactory efficacy.