CAJ | 학술논문

目的比较InterTAN髓内钉(IT)与动力髋螺钉(DHS)治疗股骨转子间骨折的疗效.方法选择行手术治疗的股骨转子间骨折患者56例,根据手术方式不同分为IT组21例和DHS组35例,比较两组术中情况(手术时间、术中出血量、切口长度、住院时间)、术后并发症(伤口感染、下肢深静脉血栓、褥疮、尿路感染、肺炎)和骨折愈合情况(骨折愈合时间、股骨颈短缩、髋内翻及髋关节Harris评分).结果 IT组手术时间、术中出血量、切口长度和住院时间均明显优于DHS组[(62.16±15.26) min比(85.78±19.50) min、(237.73±108.51) ml比(490.87±127.90) ml、(10.20±2.02) cm比(19.83±2.98) cm和(10.23±5.52)d比(15.58±5.32)d,P＜ 0.01],两组术后并发症比较差异无统计学意义(P＞0.05).IT组股骨颈短缩和髋内翻发生率明显少于DHS组[9.52％(2/21)比28.57％(10/35)和14.29％(3/21)比31.43％(11/35),P＜0.01],在骨折愈合时间及髋关节Harris评分方面两组比较差异无统计学意义(P＞0.05).结论与DHS相比,IT的应用范围更广,手术时间明显缩短,且固定可靠,更适用于治疗股骨转子间骨折.
목적 비교InterTAN수내정(IT)여동력관라정(DHS)치료고골전자간골절적료효.방법 선택행수술치료적고골전자간골절환자56례,근거수술방식불동분위IT조21례화DHS조35례,비교량조술중정황(수술시간、술중출혈량、절구장도、주원시간)、술후병발증(상구감염、하지심정맥혈전、욕창、뇨로감염、폐염)화골절유합정황(골절유합시간、고골경단축、관내번급관관절Harris평분).결과 IT조수술시간、술중출혈량、절구장도화주원시간균명현우우DHS조[(62.16±15.26) min비(85.78±19.50) min、(237.73±108.51) ml비(490.87±127.90) ml、(10.20±2.02) cm비(19.83±2.98) cm화(10.23±5.52)d비(15.58±5.32)d,P＜ 0.01],량조술후병발증비교차이무통계학의의(P＞0.05).IT조고골경단축화관내번발생솔명현소우DHS조[9.52％(2/21)비28.57％(10/35)화14.29％(3/21)비31.43％(11/35),P＜0.01],재골절유합시간급관관절Harris평분방면량조비교차이무통계학의의(P＞0.05).결론 여DHS상비,IT적응용범위경엄,수술시간명현축단,차고정가고,경괄용우치료고골전자간골절.
Objective To evaluate the clinical effect of InterTAN (IT) and dynamic hip screw (DHS) in treatment of femoral intertrochanteric fractures.Methods From July 2008 to November 2011,the patients with femoral intertrochanteric fractures were treated by IT (IT group,21 patients) and DHS (DHS group,35 patients).The intraoperative data (operative time,intraoperative blood loss,incision length and hospitalization period),postoperative complications (wound infection,lower limb deep venous thrombosis,bedsore,urinary tract infection and pneumonia) and fracture healing (fracture healing time,femoral neck crispation,coxa vara and Harris scores) were compared.Results IT group was superior to DHS group in operative time,intraoperative blood loss,incision length and hospitalization period [(62.16 ± 15.26) min vs.(85.78 ± 19.50) min,(237.73 ± 108.51) ml vs.(490.87 ± 127.90) ml,(10.20 ±2.02) cm vs.(19.83 ± 2.98) cm and (10.23 ±5.52) d vs.(15.58 ±5.32) d,P ＜0.01].However,there was no significant difference in postoperative complications (P ＞ 0.05).There was significant difference between IT group and DHS group in femoral neck crispation,coxa vara [9.52％ (2/21)vs.28.57％ (10/35),14.29％ (3/21)vs.31.43％ (11/35),P ＜ 0.01].There was no significant difference in fracture healing time and Harris scores (P ＞ 0.05).Conclusions Compared with DHS,IT has extensive application,shorter surgical time and reliable fixation effect.Therefore,IT is suitable to femoral intertrochanteric fractures.