[目的]探讨加长股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)联合钢丝捆扎治疗股骨转子间转子下骨折的临床效果。[方法]回顾性分析2018年2月—2020年6月本科收治的26例股骨转子间的股骨转子下患者的临床资料。根据医...[目的]探讨加长股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)联合钢丝捆扎治疗股骨转子间转子下骨折的临床效果。[方法]回顾性分析2018年2月—2020年6月本科收治的26例股骨转子间的股骨转子下患者的临床资料。根据医患沟通结果,13例采用单纯加长PFNA固定(未捆扎组),13例采用加长PFNA联合钢丝捆扎固定(捆扎组)。比较两组围手术期、随访及影像结果。[结果]两组患者均顺利完成手术,未捆扎组的切口长度[(8.4±1.7)cm vs(12.3±2.9)cm,P<0.001]、术中透视次数[(49.2±21.5)次vs(62.6±15.3)次,P<0.001]均显著少于捆扎组,但是,捆扎组恢复部分负重时间显著早于未捆扎组[(29.0±7.2)d vs(59.7±14.8)次,P<0.001]。随时间推移,两组患者VAS及Harris评分、髋伸-屈及髋内-外旋ROM显著改善(P<0.05)。捆扎组术后1个月VAS评分[(5.6±0.7)vs(7.3±1.0),P<0.001]、Harris评分[(64.7±8.3)vs(53.1±9.6),P<0.001]、髋伸-屈ROM[(83.2±18.9)°vs(54.7±22.3)°,P<0.001]、髋内-外旋ROM[(46.4±13.7)°vs(35.8±15.1)°,P=0.017]及术后6个月Harris评分[(82.9±7.6)vs(69.5±10.3),P<0.001]均显著优于未捆扎组。影像方面,捆扎组Baumgaertner骨折复位评级显著优于未捆扎组[优/良/差,(11/2/0)vs(3/4/6),P=0.002]。与术前相比,术后1周及末次随访时,两组颈干角、双侧股骨长度差均显著改善(P<0.05),末次随访时,捆扎组颈干角[(125.8±7.7)°vs(117.4±12.3)°,P=0.047]、双侧股骨长度差[(3.0±2.1)mm vs(4.8±3.4)mm,P=0.049]均显著优于未捆扎组。两组骨折愈合的差异无统计学意义(P>0.05)。[结论]加长PFNA联合钢丝捆扎股骨治疗转子间转子下骨折的早期效果优于单纯使用PFNA。展开更多
股骨头坏死(osteonecrosis of the femoral head,ONFH)是骨科常见病和难治性疾病,发病机制为股骨头血供受损或中断引起股骨头缺血、坏死,最终出现股骨头塌陷、关节功能障碍等症状。研究调查显示ONFH发病人数呈逐年上升趋势,好发于30~65...股骨头坏死(osteonecrosis of the femoral head,ONFH)是骨科常见病和难治性疾病,发病机制为股骨头血供受损或中断引起股骨头缺血、坏死,最终出现股骨头塌陷、关节功能障碍等症状。研究调查显示ONFH发病人数呈逐年上升趋势,好发于30~65岁人群,并逐渐趋于年轻化,其中30%~70%的病例出现双侧股骨头坏死,严重影响患者的生活[1]。按照病因ONFH主要分为创伤性股骨头坏死(traumatic-induced osteonecrosis of femoral head,TIONFH)和非创伤性股骨头坏死(non-traumatic osteonecrosis of the femoral head,NONFH),前者主要由股骨颈骨折、髋关节脱位等外伤引起,后者在我国的常见原因为糖皮质激素和酒精的过量使用[2]。展开更多
骨质疏松症(osteoporosis, OP)是最为常见的十种疾病之一,随着我国人口老龄化,骨质疏松患者逐年增加,尤其是绝经后女性远大于男性。绝经后骨质疏松症(postmenopausal osteoporosis, PMOP)在OP中发病率最高的一种,其发生与雌激素分泌降低...骨质疏松症(osteoporosis, OP)是最为常见的十种疾病之一,随着我国人口老龄化,骨质疏松患者逐年增加,尤其是绝经后女性远大于男性。绝经后骨质疏松症(postmenopausal osteoporosis, PMOP)在OP中发病率最高的一种,其发生与雌激素分泌降低,体力活动减少,营养不平衡或相对不足,以及随年龄增加,机体衰老、损伤和修复的变化,以及骨细胞和组织增殖、分化、功能减退等内在因素的综合作用所致,除此之外氧化应激、肠道菌群和铁过载都会影响PMOP的发病。蒙医称OP为“骨枯症”,本研究从蒙医对骨质疏松的药物疗法进行分析研究和展望。Osteoporosis (OP) is one of the ten most common diseases. With the aging of the population, the number of osteoporosis patients has increased year by year, especially postmenopausal women are much more than men. Postmenopausal osteoporosis (PMOP) is one of the most common forms of OP. Its occurrence is associated with decreased estrogen secretion, reduced physical activity, nutritional imbalance or relative insufficiency, and changes in aging, injury and repair as the body ages, as well as intrinsic factors such as bone cell and tissue proliferation, differentiation and dysfunction. In addition, oxidative stress, intestinal flora and iron overload affect the pathogenesis of PMOP. OP is called “bone blight disease” in Mongolian medicine. This study analyzed and studied the drug therapy of osteoporosis from Mongolian medicine.展开更多
文摘股骨头坏死(osteonecrosis of the femoral head,ONFH)是骨科常见病和难治性疾病,发病机制为股骨头血供受损或中断引起股骨头缺血、坏死,最终出现股骨头塌陷、关节功能障碍等症状。研究调查显示ONFH发病人数呈逐年上升趋势,好发于30~65岁人群,并逐渐趋于年轻化,其中30%~70%的病例出现双侧股骨头坏死,严重影响患者的生活[1]。按照病因ONFH主要分为创伤性股骨头坏死(traumatic-induced osteonecrosis of femoral head,TIONFH)和非创伤性股骨头坏死(non-traumatic osteonecrosis of the femoral head,NONFH),前者主要由股骨颈骨折、髋关节脱位等外伤引起,后者在我国的常见原因为糖皮质激素和酒精的过量使用[2]。
文摘骨质疏松症(osteoporosis, OP)是最为常见的十种疾病之一,随着我国人口老龄化,骨质疏松患者逐年增加,尤其是绝经后女性远大于男性。绝经后骨质疏松症(postmenopausal osteoporosis, PMOP)在OP中发病率最高的一种,其发生与雌激素分泌降低,体力活动减少,营养不平衡或相对不足,以及随年龄增加,机体衰老、损伤和修复的变化,以及骨细胞和组织增殖、分化、功能减退等内在因素的综合作用所致,除此之外氧化应激、肠道菌群和铁过载都会影响PMOP的发病。蒙医称OP为“骨枯症”,本研究从蒙医对骨质疏松的药物疗法进行分析研究和展望。Osteoporosis (OP) is one of the ten most common diseases. With the aging of the population, the number of osteoporosis patients has increased year by year, especially postmenopausal women are much more than men. Postmenopausal osteoporosis (PMOP) is one of the most common forms of OP. Its occurrence is associated with decreased estrogen secretion, reduced physical activity, nutritional imbalance or relative insufficiency, and changes in aging, injury and repair as the body ages, as well as intrinsic factors such as bone cell and tissue proliferation, differentiation and dysfunction. In addition, oxidative stress, intestinal flora and iron overload affect the pathogenesis of PMOP. OP is called “bone blight disease” in Mongolian medicine. This study analyzed and studied the drug therapy of osteoporosis from Mongolian medicine.
