联合加压交锁髓内固定系统治疗Evans V型转子间骨折的价值分析

摘要

Objective To investigate the value of interlocking intramedullary fixation system with integrated compression in the repair of Evans V intertrochanteric fractures. Method From January 2013 to October 2016, 96 patients with Evans V intertrochanteric fractures in our hospital were prospectively selected, they were randomly divided into observation group (n＝48) and control group (n＝48) by tossing coin method. Observation group patients adopted the interlocking intramedullary fixation system with integrated compression, while control group patients adopted the proximal femoral nail anti-rotation. The operation situation, postoperative recovery and complications of the two groups were compared. Result Compared with control group, the operation time of observation group was prolonged significantly [(54.73±13.58) min ∶ (43.28±11.74) min, P ＝ 0.000]; the amount of bleeding during the operation was increased [(318.47±74.38) ml∶(256.79±66.81) ml, P＝0.000]; the fracture healing time was shorted significantly [(101.31±10.21) d∶(113.06±11.28) d, P＝0.000]. There was no significant difference in the Harris scores between the two groups before and 6 months after operation (P＞0.05). The Harris score of observation group at 12 months after operation was significantly higher than that of control group [(81.65±5.49) ∶ (78.69±4.83), P ＝ 0.006]. There was no significant difference in postoperative complications between the two groups (P＞0.05). Conclusion Interlocking intramedullary fixation system with integrated compression improves the postoperative function recovery in patients with Evans V intertrochanteric fractures.%目的 探讨联合加压交锁髓内固定系统治疗Evans V型转子间骨折的价值.方法 选取2013年1月至2016年10月本院收治的Evans V型转子间骨折患者96例为研究对象,采用投掷硬币法将其随机分为观察组(48例)和对照组(48例),观察组患者采用联合加压交锁髓内固定系统治疗,对照组患者采用单钉股骨近端髓内固定治疗.观察两组患者手术情况、术后恢复情况及并发症发生情况.结果 与对照组比较,观察组患者手术时间显著延长([ 54.73±13.58)分钟∶(43.28±11.74)分钟,P＝0.000] ;术中出血量显著增加[(318.47±74.38)ml∶(256.79±66.81)ml,P＝0.000] ;骨折愈合时间显著缩短([ 101.31±10.21)天∶(113.06±11.28)天,P＝0.000].两组患者术前和术后6个月Harris评分比较均无显著差异(P＞0.05).观察组患者术后12个月Harris评分显著高于对照组[(81.65±5.49)分∶(78.69±4.83)分,P＝0.006].两组患者术后并发症发生率比较无显著差异(P＞0.05).结论 联合加压交锁髓内固定系统可改善Evans V型转子间骨折患者术后功能康复.