中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (52): 9750-9755.doi: 10.3969/j.issn.1673-8225.2011.52.014

• 人工假体 artificial prosthesis • 上一篇    下一篇

老年股骨转子间骨折伴小转子移位大于2 cm行小转子复位固定对髋关节功能的影响：前瞻随机对照

吕发明1，程国杰1，陈平波1，李文富2，贾卫东3，张  波2，吕  刚1，艾克巴尔1，杨  春1，融  恺1，胡  飞1   

  1. 1新疆维吾尔自治区中医医院创伤骨科，新疆维吾尔自治区乌鲁木齐市  830000
    2乌鲁木齐市中医医院骨科，新疆维吾尔自治区乌鲁木齐市  830000
    3乌鲁木齐市第一人民医院骨科，新疆维吾尔自治区乌鲁木齐市830000
  • 收稿日期:2011-09-27 修回日期:2011-10-11 出版日期:2011-12-24 发布日期:2011-12-24
  • 通讯作者: 程国杰，硕士，主治医师，新疆维吾尔自治区中医医院创伤骨科，新疆维吾尔自治区乌鲁木齐市 830000 cgjsohu.com@sohu.com
  • 作者简介:吕发明，男，1957年生，山东省枣庄市人，汉族，1984年新疆中医学院毕业，教授、主任医师，主要从事创伤骨科疾病的中西医结合治疗，慢性软组织损伤的基础及临床研究。 LvfamingOK@163.com
  • 基金资助:

    乌鲁木齐市科技计划项目资助(Y09231002)，课题名称：股骨近端髓内钉治疗股骨转子间骨折的技术研究与推广应用。

Effect of entotrochanter reduction and fixation on hip joint function of elderly intertrochanteric fracture patients with entotrochanter displacement over 2 cm: A prospective randomized controlled study

Lü Fa-ming1, Cheng Guo-jie1, Chen Ping-bo1, Li Wen-fu2, Jia Wei-dong3, Zhang Bo2, Lü Gang1, Ai Ke Ba Er1 , Yang Chun1, Rong Kai1, Hu Fei1   

  1. 1Department of Orthopedic Trauma, Traditional Chinese Medical Hospital of Xinjiang Uygur Autonomous Region, Urumqi  830000, Xinjiang Uighur Autonomous Region, China
    2Department of Orthopedics, Urumqi Hospital of Traditional Chinese Medicine, Urumqi  830000, Xinjiang Uygur Autonomous Region, China
    3Department of  Orthopedics, Urumqi First People's Hospital, Urumqi  830000, Xinjiang Uygur Autonomous Region, China
  • Received:2011-09-27 Revised:2011-10-11 Online:2011-12-24 Published:2011-12-24
  • Contact: Cheng Guo-jie, Master, Attending physician, Department of Orthopedic Trauma, Traditional Chinese Medical Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China cgjsohu.com@sohu.com
  • About author:Lü Fa-ming, Professor, Chief physician, Department of Orthopedic Trauma, Traditional Chinese Medical Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China LvfamingOK@163.com
  • Supported by:

    Project of Science and Technology Foundation of Urumqi City, No. Y09231002*

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摘要：

背景：股骨转子间骨折伴小转子移位大于2 cm是否需要复位固定仍有争议。
目的：探讨对老年股骨转子间骨折伴小转子移位大于2 cm复位固定的临床价值。
方法：纳入新疆维吾尔自治区中医医院创伤骨科2010-01/2011-03收治的70例老年股骨转子间骨折伴小转子移位大于2 cm的患者，分别进行小转子复位固定(实验组，n=35)和不复位固定(对照组，n=35)。股骨转子间骨折均采用髓内系统固定，小转子移位用钢丝或螺钉固定。分别于固定后1，3，6，12个月对患者进行随访。
结果与结论：随访期间，两组患者均未出现内固定松动及断钉现象，未发现感染。两组患者骨折愈合时间差异均无显著性意义(P > 0.05)。髋关节评分结果显示，固定后1个月，实验组优于对照组，固定后3，6，12个月，两组间比较差异均无显著性意义。说明小转子复位固定对老年股骨转子间骨折伴小转子移位大于2 cm的患者近期疗效明显，但如患者一般状况较差，建议不必复位固定小转子。

关键词: 股骨转子间骨折, 老年, 小转子, 复位固定, 股骨近端髓内钉, 随机对照试验

Abstract:

BACKGROUND: It is unclear that whether intertrochanteric fracture accompanied with entotrochanter displacement over 2 cm requires reduction and fixation.
OBJECTIVE: To explore the clinical value of entotrochanter reduction and fixation of elderly intertrochanteric fracture patients with entotrochanter displacement over 2 cm.
METHODS: Seventy elderly intertrochanteric fracture patients with entotrochanter displacement over 2 cm selected from the Department of Orthopedic Trauma, Traditional Chinese Medical Hospital of Xinjiang Uygur Autonomous Region, from January 2010 to March 2011 were enrolled. Patients undergoing entotrochanter reduction and fixation served as experiment group (n=35) and those without reduction as control group (n=35). Intertrochanteric fracture was fixed by intramedullary system, while entotrochanter displacement was treated by wire or screw fixation. The patients were followed up at 1, 3, 6, 12 months after surgery.
RESULTS AND CONCLUSION: There was no internal fixation loosening, broken nail and infection in both groups during the follow-up. The healing time of the two groups had no significant difference (P > 0.05). The score of hip function in the experiment group was better than that in the control group at 1 month after surgery; however, at 3, 6, 12 months after surgery, the differences were non-significant. The results showed that entotrochanter reduction and fixation was suitable for elderly intertrochanteric fracture patients with entotrochanter displacement over 2 cm based on its obvious short-term effects, but patients with poor general condition were not recommended.

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