髓内钉与锁定解剖钢板治疗不稳定股骨转子间骨折的比较

潘文奇

【摘要】 目的：比较髓内钉与锁定解剖钢板治疗不稳定股骨转子间骨折效果。方法：选取2015年4月-2016年4月在笔者所在医院接受治疗的不稳定股骨转子间骨折患者48例为研究对象，采用双目盲选法将其分为试验组和对照组，各24例，对照组患者予以锁定解剖钢板方法治疗，试验组患者予以髓内钉内固定治疗，比较两组患者的临床治疗效果。结果：试验组患者的手术时间、透视时间、痊愈时间均明显短于对照组，术中失血量明显少于对照组，比较差异均有统计学意义（P<0.05）；试验组患者的Harris评分优良率为95.83%，明显高于对照组的79.17%，比较差异有统计学意义（P<0.05）；试验组中并发症发生率为0，明显低于对照组的16.67%，比较差异有统计学意义（P<0.05）。结论：对不稳定股骨转子间骨折患者予以髓内钉治疗能够优化各项手术指标，改善患者的髋关节功能水平，降低并发症发生率效果显著，值得在临床当中推广运用。

【关键词】 髓内钉； 锁定解剖钢板； 不稳定股骨转子间骨折

doi：10.14033/j.cnki.cfmr.2018.4.006 文献标识码 B 文章编号 1674-6805（2018）04-0012-03

Comparison of Intramedullary Nail and Locked Anatomical Plate in Treating Unstable Intertrochanteric Fractures/PAN Wenqi.//Chinese and Foreign Medical Research，2018，16（4）：12-14

【Abstract】 Objective：To compare the effect of intramedullary nail and locking anatomical plate in the treatment of unstable intertrochanteric fractures.Method：From April 2015 to April 2016，48 patients with unstable femoral intertrochanteric fractures treated in our hospital were selected as the subject，and were divided into experimental group and control group by binocular blindness，24 cases in each group.Patients in the control group were treated by anatomical plate locking method，and patients in the experimental group were treated with intramedullary nailing，and the clinical effects of the two groups were compared.Result：The operation time，the time of fluoroscopy and the cure time in the experimental group were significantly shorter than those in the control group，and the blood loss was significantly less in the experimental group than that in the control group，with statistical significance（P<0.05）.The Harris score of the experimental group was 95.83%，significantly higher than 79.17% of the control group，with significant difference（P<0.05）.The incidence of complications in the experimental group was 0，significantly lower than 8.33% in the control group，the difference was statistically significant（P<0.05）.Conclusion：The treatment of unstable intertrochanteric fractures in patients with intramedullary nail can optimize the surgical indexes，improve the hip function and reduce the incidence of complications.It is worth promoting in the clinical application.

【Key words】 Intramedullary nail； Locking anatomical plate； Unstable femoral intertrochanteric fracture

First-authors address：Binyang County Peoples Hospital，Binyang 530405，China

股骨轉子间骨折是在股骨颈基底至小转子水平以上部位发生的骨折，由直接暴力或间接暴力所致，在老年人当中尤为多发[1-3]。手术治疗是此种骨折的主要治疗方法，锁定解剖钢板与髓内钉内固定是治疗不稳定股骨转子间骨折的两种主要术式，在临床当中均较为多用，对于两种手术方式孰优孰劣一直存在较大的争议。本研究以笔者所在医院患者为研究对象，比较分析两种手术方式在临床中的应用价值。

1 资料与方法

1.1 一般资料

选取2015年4月-2016年4月在笔者所在医院接受治疗的不稳定股骨转子间骨折患者48例，符合纳入与排除标准[3]，且全部患者均知情同意。将选定的48例患者按照双目盲选法分为试验组和对照组，每组24例。试验组中男14例，女10例；年龄35～72岁，平均（58.97±4.38）岁；改良Evans分型：Ⅲ型8例，Ⅳ型5例，Ⅴ型7例，Ⅵ型4例。对照组中男14例，女10例；……