拉线法在判断术中粉碎性粗隆间骨折旋转移位的临床研究

摘要

AIM: To clinically validate the reliability of lower limb physiological alignment measurement method in judging rotation displacement of comminuted intertrochanteric fracture during opera?tion, and to provide guidance for intraoperative reduction. METH?ODS:The lower limb physiological alignment measurement method (wire pulling method) was used to determine the reduction of 34 rotational displacement patients with comminuted femoral intertro?chanteric fracture during operation. At the same time, three?dimen?sional spiral CT was used to measure the femoral neck anteversion angle of both lower extremities. Then, the difference of femoral neck anteversion between the uninjured side and the injured side was calculated to evaluate the accuracy of this method. The stand?ard of rotation reduction after operation is as follows. Excellent:the difference value was less than 5°;Good:5°~10°;Feasible:11°~15°;Poor:the difference value was more than 15°. RESULTS:Three?dimensional spiral CT was used to calculate the bilateral anteversion angle of 34 patients, and the differences were calculated. Among them, 13 patients ’ bilateral anteversion angle was less than 5°, which was excellent and accounted for 38. 23%; A total of 15 patients’ bilateral anteversion angle was 5°~10°, which was good and accounted for 44%; A total of 3 patients’ bilateral anteversion angle was 11°~15°, which was feasible and accounted for 8.8%;A total of 3 patients’ bilateral anteversion angle was more than 15°, which was bad and accounted for 8.8%. The excellent and good rate was 82.23%. CONCLUSION:It was a reliable method to determine the reduction of rotationa displacement of comminuted femoral intertr ochanteric fracture during operation by using lower limb physiological alignment measurement method (wire pulling method).%目的：对下肢生理力线测量法判断术中粉碎性股骨粗隆间骨折旋转移位的可靠性进行临床验证，为术中复位提供指导．方法：利用下肢生理力线测量法（拉线法）来判断术中粉碎性股骨粗隆间骨折旋转移位的复位患者34例，同时术后三维螺旋CT测量双下肢股骨颈前倾角，通过计算健侧与伤侧前倾角的差值来评价此法判断旋转复位的准确性．术后评价旋转复位程度的标准如下．优：差值＜5°；良：5°～10°；可：11°～15°；差：＞15°．结果：通过三维螺旋 CT 计算34例患者的双侧前倾角，并进行差值计算，＜5°13例，优占38．23％；5°～10°15例，良占44％；11°～15°3例，可占8．8％；＞15°3例，差占8．8％．优良率为82．23％．结论：利用人体下肢生理力线法（拉线法）可判断术中粉碎性股骨粗隆间骨折旋转移位的复位，是一种可靠的方法．