小切口辅助复位配合防旋髓内钉对股骨转子间骨折患者手术出血及疼痛症状的影响

Effect of mini-incision assisted reduction combined with antirotation intramedullary nail on surgical bleeding and pain symptoms of patients with femoral intertrochanteric fracture

目的股骨转子间骨折小切口辅助复位配合防旋髓内钉治疗对手术出血量及疼痛症状的影响。方法回顾性分析2021年1月至2022年12月于山东第二医科大学附属医院关节外科治疗的84例股骨转子间骨折患者,依据方案分为对照组和研究组,每组各42例。对照组实施完全闭合复位,研究组实施小切口辅助复位,比较两组术中情况、术后并发症发生情况以及髋关节评分(Harris)、视觉模拟评分法(VAS)评分。结果研究组治疗后切口长度、术中出血量、手术时间均高于对照组,差异有统计学意义(P<0.05),而骨折愈合时间短于对照组,差异有统计学意义(P<0.05);研究组治疗后死亡、下肢静脉栓塞、内固定物穿出股骨头、骨折不愈合并发症总发生率低于对照组,差异有统计学意义(P<0.05);两组治疗后的Harris评分均高于治疗前,且VAS评分低于治疗前,差异有统计学意义(P<0.05),但两组治疗后Harris、VAS评分比较,差异无统计学意义(P>0.05)。结论在股骨转子间骨折患者的治疗中,与闭合复位措施相比,虽然小切口辅助复位方案术中出血量及手术时间有所增加,但术后并发症较对照组减少,骨折愈合时间短,而且关节功能情况缓解明显。

Objective To investigate the effect of mini-incision assisted reduction combined with anti-rotation intramedullary nail on blood loss and pain symptoms of femoral intertrochanteric fracture.Methods A total of 84 patients with femoral intertrochanteric fracture who were treated in the Department of Joint Surgery,Affiliated Hospital of Shandong Second Medical University from January 2021 to December 2022 were retrospectively analyzed.According to the regimen,they were divided into the control group and the study group,with 42 patients in each group.The control group received complete close reduction,while the study group received mini-incision assisted reduction.The intraoperative situation,postoperative complications,Harris hip score(Harris)and visual analogue scale(VAS)of the two groups were compared.Results After treatment,the incision length,intraoperative blood loss and operation time in the study group were higher than those in the control group,with statistically significant differences(P<0.05),while the time to fracture healing was shorter than that in the control group,with statistically significant difference(P<0.05).The total incidence of complications such as death,lower limb venous embolism,internal fixator penetrating the femoral head,and fracture nonunion after treatment in the study group was lower than that in the control group,with statistically significant difference(P<0.05).Harris score in both groups after treatment was higher than that before treatment,and VAS score after treatment was lower than that before treatment,with statistically significant differences(P<0.05),but there was no statistical difference in Harris and VAS scores after treatment between the study group and the control group(P>0.05).Conclusion In the treatment of patients with femoral intertrochanteric fracture,compared with the complete close reduction regimen,although the intraoperative blood loss and operation time in the mini-incision assisted reduction regimen increased slightly,the postoperative complications decreased,the time to fracture healing was short er,and significantly relieved the joint function.