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Comparison of two methods of locating proximal femoral nail anti-rotation in the treatment of femoral intertrochanteric fractures
Journal of Orthopaedic Surgery and Research ( IF 2.8 ) Pub Date : 2020-03-17 , DOI: 10.1186/s13018-020-01614-9
Rong-hua Tian , Qin-ming Zhang , Feng-long Chu , Xiao-yan Li , Zhen Jiang , Liang Han , Peng Sun , Hai-bin Wang , Yu-lei Chi , Bin Wu

To compare the efficacy of three-point locating versus routine locating techniques for implanting helical blades for proximal femoral nail anti-rotation-II in the treatment of trochanteric fractures. From January 2010 to June 2013, 90 patients with intertrochanteric fractures were surgically treated, including 48 males and 42 females with an average age of 70.5 ± 7.2 years. According to the AO classification, there were 45 cases of A2.1, 35 cases of A2.2, and 10 cases of A2.3. Based on locating techniques, the 90 patients were divided into two groups: the three-point group and the routine group, with 45 patients in each group. All operations were performed by the same group of surgeons using proximal femoral nail anti-rotation (PFNA); the helical blade was inserted into the femoral neck with the three-point locating technique or by the usual method according to treatment group. Several figures including total operation time, elapsed time for implanting the helical blade, intraoperative blood loss, X-ray exposure time, and tip-apex distance (TAD) were measured and compared. The three-point group was significantly superior as compared to the routine group in terms of total operation time [(59.34 ± 9.42) min vs (67.61 ± 12.63) min, P < 0.01], elapsed time for implanting the helical blade [(4.58 ± 1.25) min vs (7.82 ± 2.19) min, P < 0.01], intraoperative blood loss [(92.78 ± 34.09) ml vs (154.01 ± 39.10) ml, P < 0.01], X-ray exposure time [(8.84 ± 1.45) vs (14.62 ± 2.91), P < 0.01], and tip-apex distance [(16.78 ± 1.55) mm vs (21.91 ± 3.01) mm, P < 0.01]. Among the 90 patients, 80 were followed up for an average time of 12 months (10–15 months), including 42 patients who were part of three-point group and 38 patients who were part of the routine group. No spiral blade cut was found on the femoral head in any patient in the three-point group, whereas it occurred in 2 patients in the routine group 1 month after surgery. However, there was no significant difference in the Harris score between the two groups 6 months after the operation. The three-point locating method is faster and more accurate than the routine locating method.

中文翻译:

两种定位股骨近端钉抗旋转的方法治疗股骨转子间骨折的比较

为了比较三点定位与常规定位技术为股骨近端钉抗旋转-II植入螺旋形刀片治疗股骨转子骨折的疗效。从2010年1月至2013年6月,对90例股骨转子间骨折患者进行了手术治疗,其中男48例,女42例,平均年龄70.5±7.2岁。根据AO分类,有A2.1例45例,A2.2例35例,A2.3例10例。根据定位技术,将90例患者分为两组:三点组和常规组,每组45例。所有手术均由同一组外科医生使用股骨近端钉防旋转(PFNA)进行;根据治疗组,采用三点定位技术或常规方法将螺旋刀片插入股骨颈。测量并比较了包括总手术时间,植入螺旋刀的经过时间,术中失血量,X射线照射时间和针尖距离(TAD)在内的数个数字。三点组的总手术时间[(59.34±9.42)min vs(67.61±12.63)min,P <0.01],螺旋刀植入时间[[4.58]明显优于常规组。 ±1.25)分钟vs(7.82±2.19)分钟,P <0.01],术中失血[(92.78±34.09)ml vs(154.01±39.10)ml,P <0.01],X射线暴露时间[(8.84±1.45) )vs(14.62±2.91),P <0.01]和尖端距离[(16.78±1.55)mm vs(21.91±3.01)mm,P <0.01]。在90例患者中,有80例接受了平均12个月(10-15个月)的随访,其中42例属于三点治疗组,38例属于常规治疗组。三点组中的任何患者均未在股骨头上发现螺旋状刀片割伤,而常规组中有2例在手术后1个月发生。然而,术后6个月,两组之间的Harris评分没有显着差异。三点定位方法比常规定位方法更快,更准确。三点组中的任何患者均未在股骨头上发现螺旋状刀片割伤,而常规组中有2例在手术后1个月发生。然而,术后6个月,两组之间的Harris评分没有显着差异。三点定位方法比常规定位方法更快,更准确。三点组中的任何患者均未在股骨头上发现螺旋状刀片割伤,而常规组中有2例在手术后1个月发生。然而,术后6个月,两组之间的Harris评分没有显着差异。三点定位方法比常规定位方法更快,更准确。
更新日期:2020-03-19
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