中国组织工程研究

中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (44): 7137-7141.doi: 10.3969/j.issn.2095-4344.2015.44.016

• 骨科植入物 orthopedic implant • 上一篇    下一篇

股骨近端髓内钉修复青年股骨转子周围骨折：3个月随访关节功能及并发症

杨立明1，谢直跃1，熊  敏2   

  1. 1成都市第一人民医院骨科，四川省成都市  610000；2湖北医药学院，湖北省十堰市  442000
  • 收稿日期:2015-09-02 出版日期:2015-10-22 发布日期:2015-10-22
  • 通讯作者: 谢直跃，副主任医师，成都市第一人民医院骨科，四川省成都市610000
  • 作者简介:杨立明，男，1978年生，四川省都江堰市人，汉族，主治医师，主要从事创伤关节方面的研究。
  • 基金资助:

    湖北省教育厅课题(B20112115)：一种骨诱导性小分子mBMP的发现及其骨修复性能的评价

Proximal femoral intramedullary nail fixation for treating intertrochanteric fractures in young patients: joint function and complications in 3-month follow-up

Yang Li-ming1, Xie Zhi-yue1, Xiong Min2   

  1. 1Department of Orthopedics, Chengdu First People’s Hospital, Chengdu 610000, Sichuan Province, China; 2Hubei University of Medicine, Shiyan 442000, Hubei Province, China
  • Received:2015-09-02 Online:2015-10-22 Published:2015-10-22
  • Contact: Xie Zhi-yue, Associate chief physician, Department of Orthopedics, Chengdu First People’s Hospital, Chengdu 610000, Sichuan Province, China
  • About author:Yang Li-ming, Attending physician, Department of Orthopedics, Chengdu First People’s Hospital, Chengdu 610000, Sichuan Province, China
  • Supported by:

    the Project of Hubei Province Education Department, No. B20112115

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摘要：

背景：股骨近端骨折通常首选生物力学坚强的髓内钉固定，而股骨近端髓内钉能有效控制骨折的短缩和旋转，允许患者早期活动和负重，促进关节功能的改善。
目的：观察股骨近端髓内钉修复青年人股骨转子周围骨折对术后关节功能恢复的影响。
方法：采用随机数字表法将80例青年股骨转子周围骨折患者分为治疗组与对照组，每组40例。对照组给予动力髋螺钉内固定治疗，治疗组给予股骨近端髓内钉内固定治疗。对比两组患者的围手术期指标、并发症与治疗后3个月膝关节功能恢复情况。
结果与结论：与对照组相比，治疗组患者的切口长度、术中出血量、手术时间、治疗后骨折愈合时间以及治疗后下地活动时间都显著减少(P < 0.05)。治疗组治疗后骨不连、髋内翻、患肢短缩、深静脉血栓等并发症发生情况明显少于对照组(P < 0.05)。治疗后3个月经过随访，治疗组的髋关节优良率显著高于对照组(93%，80%，P < 0.05)。提示股骨近端髓内钉修复青年人股骨转子周围骨折遵循生物力学原则，体现了微创的特点，且修复后并发症比较少，有利于促进髋关节功能的恢复。
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 骨科植入物, 骨植入物, 股骨近端髓内钉, 股骨转子周围骨折, 力髋螺钉, 关节功能, 青年人

Abstract:

BACKGROUND: Intramedullary nail with rigid biomechanics was firstly selected for proximal femoral fracture. Proximal femoral intramedullary nail can effectively control the shortening and rotation of the fracture, allow patients to do early exercise and weight bearing, and promote the improvement of joint function.
OBJECTIVE: To investigate the effects of proximal femoral intramedullary nail for treating intertrochanteric fractures on the recovery of joint function in young patients. METHODS: 80 young patients with intertrochanteric fractures were randomly divided into the treatment group and the control group, with 40 cases in each group. The control group received dynamic hip screw fixation, and the treatment group received proximal femoral nail fixation. Perioperative index, complications and functional recovery of knee joint after 3 months of treatment were compared between the two groups.
RESULTS AND CONCLUSION: Compared with the control group, length of incision, intraoperative blood loss, operative time, fracture healing time and postoperative ambulation time were significantly reduced in the treatment group (P < 0.05). Complications such as postoperative nonunion, hip varus, limb shortening and deep vein thrombosis were significantly less in the treatment group than in the control group (P < 0.05). After follow-up 
at 3 months post treatment, the excellent and good rate of hip function was significantly higher in the treatment group than in the control group (93%, 80%; P < 0.05). These results suggest that proximal femoral nail for treating intertrochanteric fractures in young patients follows the principle of biomechanics, reflects the characteristics of minimal invasion, and has few complications, and promotes the recovery of hip function. 
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Femoral Fractures, Internal Fixators, Postoperative Complications, Follow-Up Studies, Tissue Engineering