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Intertan髓内钉治疗股骨粗隆间骨折术中闭合复位丢失的临床研究
Clinical study on loss of reduction during the operation in the treatment of intertrochanteric femoral fracture using Intertan intramedullary nail
  
DOI:
中文关键词:  股骨粗隆间骨折  Intertan髓内钉  闭合复位  临床研究
英文关键词:Intertrochanteric femoral fracture  Intertan intramedullary nail  Closed reduction  Clinical study
基金项目:
作者单位
张明 刘长松 范步新 刘新民 曲先芳 王祥立 管波青 刘书茂  
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中文摘要:
      目的 分析Intertan髓内钉治疗股骨粗隆间骨折术中闭合复位丢失的相关因素并探讨相应对策。方法 回顾2011年1月至2017年6月,我院采用Intertan髓内钉治疗股骨粗隆间骨折,术中闭合复位丢失59例,获得随访56例,死亡2例,失访1例。收集患者术前基本资料,术中指标,术后恢复情况。对所收集的资料进行统计学分析,数值变量用均数±标准差(X±s )表示。结果 骨折复位(例):正性内侧皮质支撑39,中性支撑10,负性支撑7。Harris评分平均85.7±9.86分。56例入钉点的位置分布(例):居中42;偏前3;偏后6;偏内1;偏外4例。出现移位的情况(例),入钉点位置14;螺纹针开口4,开口器开口8;开口钻钻入10;插入主钉8;拧入粗拉力螺钉6;拧入交锁螺钉6。结论 Intertan髓内钉可有效的治疗股骨粗隆间骨折;而掌握入钉点位置、开口方式、开口钻的方法、主钉及拉力螺钉的拧入方式等,能解决术中出现闭合复位丢失的现象。
英文摘要:
      Objective To analyse the related factors and corresponding counter-measures of loss of reduction during the operation in the treatment of intertrochanteric femoral fracture with Intertan intramedullary nail. Methods It is a retrospective study in which 59 patients with intertrochanteric femoral fracture were treated by closed reduction with Intertan fixation from 2011 January to 2017 June. 56 cases were followed up, 2 cases died and 1 case dropped out. The general characteristic, intraoperative events and postoperative variable were collected for statistical analysis. The numerical variables were demonstrated as mean ± standard deviation (X±s). Results The reduction status of fracture were (case): positive medial cortex support 39, neutral position 10, negative medial cortex support 7. The average Harris score was 85.7 ±9.86. The distribution of Intertan entrance point (case) were: middle 42, anterior 3, posterior 6, medial 1, lateral 4. Loss of reduction occurred in the following procedures(case): nailing entrance 14, screw thread opening 4, opener opening 8, reamer drilling 10, inserting main nail 8, screwing lag screw 6, screwing interlocking screw 6. Conclusion Intertan intramedullary nail can effectively treat intertrochanteric femoral fracture.Grasp the position of Intertan entrance point, the method of opening, the drilling method of the opening, the method of screw and etc can solve the phenomenon of closed reduction loss during operation.
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