胸骨钢丝捆绑与钢板固定大转子方式在不稳定股骨转子间骨折患者人工股骨头置换术中的应用及疗效比较

doi:10.13481/j.1671-587x.20190335

吉林大学学报(医学版) ›› 2019, Vol. 45 ›› Issue (03): 678-682.doi: 10.13481/j.1671-587x.20190335

• 临床医学 • 上一篇

胸骨钢丝捆绑与钢板固定大转子方式在不稳定股骨转子间骨折患者人工股骨头置换术中的应用及疗效比较

钟磊¹, 方红娟², 许猛¹, 侯婷婷¹, 侯越超¹, 王明礼¹

1. 吉林大学第二医院骨科, 吉林长春 130021;
2. 吉林大学第四医院电诊科, 吉林长春 130000

收稿日期:2018-02-12 发布日期:2019-06-05
通讯作者: 王明礼,主任医师,硕士研究生导师(Tel:0431-81136390,E-mail:huijiazoro129@163.com) E-mail:huijiazoro129@163.com
作者简介:钟磊(1982-),男,安徽省合肥市人,主治医师,医学博士,主要从事不同年龄段髋部疾病诊断和治疗方面的研究。
基金资助:
吉林省教育厅"十三五"科学技术研究规划项目资助课题（JJKH20170869KJ）

Comparison of application and curative effects between sternal wire binding and plate fixation of greater trochanter in artificial femoral head replacement of patients with unstable intertrochanteric fracture

ZHONG Lei¹, FANG Hongjuan², XU Meng¹, HOU Tingting¹, HOU Yuechao¹, WANG Mingli¹

1. Department of Orthopedic, Second Hospital, Jilin University, Chang chun 130021, China;
2. Department of Electric Diagnosis, Fourth Hospital, Jilin University, Changchun 130000, China

Received:2018-02-12 Published:2019-06-05

摘要/Abstract

摘要： 目的：观察不稳定股骨转子间骨折老年患者人工股骨头置换术中采用胸骨钢丝捆绑和钢板固定大转子方式的疗效，为其治疗提供依据。方法：52例高龄转子间不稳定骨折患者，依据大转子处骨折粉碎程度分为胸骨钢丝捆绑组（采用胸骨钢丝捆绑固定大转子，n=28）和钢板固定组（采用钢板固定大转子，n=24）。观察2组患者的手术时间，出血量，术后引流量，患者初次下地时间，术后并发症发生率，出院时和术后1个月、3个月、6个月、12个月髋关节功能的Harris评分。结果：胸骨钢丝捆绑组患者手术时间少于钢板固定组（P<0.05）；出血量少于钢板固定组（P<0.05）；术后引流量，患者初次下地时间，术后并发症发生率，出院时和术后1个月、3个月、6个月、12个月髋关节功能的Harris评分组间比较差异无统计学意义（P>0.05）。结论：与钢板固定大转子比较，不稳定股骨转子间骨折患者人工股骨头置换术中采用胸骨钢丝捆绑固定大转子具有手术时间短、术中出血少、术后髋关节功能恢复好的优势，适于临床推广。

关键词: 胸骨钢丝捆绑, 钢板固定, 大转子撕脱, 股骨转子间骨折

Abstract: Objective:To observe the curative effects of artificial femoral head replacement using sternal wire binding and plate fixation in the treatment of the patients with unstable intertrochanteric fracture, and to provide the basis for its treatment. Methods:A total of 52 elderly patients with intertrochanteric fracture treated with artificial femoral head replacement were divided into sternal wire binding group (the patients were given sternal wire binding of greater trochanter,n=28) and plate fixation group (the patients were given plate fixation of greater trochanter,n=24). The operation time, blood loss, the drainage volumes after operation, the time of getting off the bed first, the incidences of early complications, and the Harris scores of hip joint at the discharge time and 1 month, 3 months, 6 months and 12 months after operation of the patients in two groups were recorded. Results:Compared with plate fixation group, the operation time of the patients in sternal wire binding group was decreased (P<0.05), the blood loss of the patients in sternal wire binding group was decreased (P<0.05), but there were no significant differences in the drainage volumes after operation, the time of getting off the bed first, the incidences of complications after operation, and the Harris scores of hip joint at the discharge time and 1 month,3 months, 6 months, and 12 months after operation of the patients between two groups(P>0.05). Conclusion:Compared with plate fixation, sternal wire binding of the greater trochanter in femoral head replacement in the treatment of the patients with unstable intertrochanteric fracture has the advantages of shorter operative time, less blood loss volume,better postoperative recovery of hip joint function,which is suitable for the clinical application.

Key words: sternal wire binding, plate fixation, avulsion of greater trochanter, intertrochanteric fracture

中图分类号:

R684

钟磊, 方红娟, 许猛, 侯婷婷, 侯越超, 王明礼. 胸骨钢丝捆绑与钢板固定大转子方式在不稳定股骨转子间骨折患者人工股骨头置换术中的应用及疗效比较[J]. 吉林大学学报(医学版), 2019, 45(03): 678-682.

ZHONG Lei, FANG Hongjuan, XU Meng, HOU Tingting, HOU Yuechao, WANG Mingli. Comparison of application and curative effects between sternal wire binding and plate fixation of greater trochanter in artificial femoral head replacement of patients with unstable intertrochanteric fracture[J]. Journal of Jilin University(Medicine Edition), 2019, 45(03): 678-682.

参考文献

[1] POLAT M, ARSLAN A, UTKAN A. External fixation versus hemiartroplasty in unstable intertrochanteric hip fractures of the elderly[J]. Acta Orthopaed Belg, 2017, 88(3):351-359.
[2] HEINI P F. Femoroplasty-augmentation of mechanical properties in the osteoporotic proximal femur:a biomechanical investigation of PMMA reinforcement in cadaver bones[J]. Clin Biomech (Bristol, Avon), 2004,19(5):506-512.
[3] KANG S Y, LEE E W, KANG K S, et al. Mode of fixation failures of dynamic hip screw with TSP in the treatment of unstable proximal femur fracture:biomechanical analysis and a report of 3 cases[J]. J Korean Orthop Assoc,2006,41(1):176-180.
[4] 张志山, 周方, 田耘,等. 反向微创内固定系统治疗特殊类型股骨近端骨折[J]. 中华创伤杂志, 2009, 25(1):48-52.
[5] KEE H. Is rigid fixation of the greater trochanter necessary for arthroplasty of intertrochanteric fractures?[J]. Orthopaed Traumatol Surg Res, 2018, 26(2):48-54.
[6] CUI Q. Cemented hip hemiarthroplasty clinical observations on unstable intertrochanteric fracture in elderlies[J]. Eur J Trauma Emerg Surg, 2016, 42(5):651-656.
[7] 孙维国, 李皓桓, 彭飞, 等. 采用Wagner假体行人工股骨头置换治疗高龄股骨粗隆间不稳定骨折的疗效观察[J]. 武汉大学学报:医学版, 2014, 35(4):613-616.
[8] 郭小微, 李开南. 股骨粗隆间骨折手术风险评分系统的研究[J]. 中国骨与关节损伤杂志, 2014, 29(8):759-762.
[9] HWANG D S, KWAK S K, WOO S M. Results of cementless hemiarthroplasty for elderly patients with unstable intertrochanteric fractures[J]. J Korean Hip Soc,2004,16(3):386-391.
[10] JAHNG J H, SOHN J M, HA N K, et al. Primary bipolar hemiarthroplasty for treatment of unstable intertrochanteric fracture of the femur in elderly patients[J]. J Korean Hip Soc,2005,17(2):76-82.
[11] STOFFELEN D, HAENTJENS P, REYNDERS P, et al. Hip arthroplasty for failed internal fixation of intertrochanteric and subtrochanteric fractures in the elderly patient[J]. Acta Orthop Belg,1994,60(Suppl 1):135-139.
[12] TABSH I, WADDELL JP, MORTON J, et al. Total hip arthroplasty for complications of proximal femoral fractures[J]. J Orthop Trauma, 1997,11(3):166-169.
[13] CHAN K C, GILL G S. Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures[J]. Clin Orthop Relat Res, 2000,(371):206-215.
[14] SIDHU A S, SINGH A P. Total hip replacement as primary treatment of unstable intertrochanteric fractures in elderly patients[J]. Int Orth,2010,34(6):789-792.
[15] 储小兵, 杨予, 郝改平, 等. 新研制的老年不稳定型股骨粗隆间骨折半髋假体有限元分析[J]. 中国生物医学工程学报, 2012, 31(5):729-735.
[16] 张明辉, 武豪杰, 陈欣欣, 等. 人工股骨头置换术治疗高龄不稳定股骨粗隆间骨折术中大粗隆骨折不同固定方法的比较[J]. 中国骨与关节损伤杂志, 2015, 30(10):1090-1092.
[17] YANG E. New concepts in pertrochanteric hip fracture treatment[J]. Orthopedics, 2006, 29(11):981-983.
[18] 谢庆云, 张波, 权毅, 等. 人工双极股骨头置换中大转子不同固定方法的比较[J]. 中国组织工程研究与临床康复, 2011, 15(26):4781-4784.
[19] KIM Y, MOON J K, HWANG K T, et al. Cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in octogenarians[J]. Acta Orthop Traumatol Turc,2014, 48(4):424-430.
[20] LEE Y K, HA Y C, CHANG B K, et al. Cementless bipolar hemiarthroplasty using a hydroxyapatite-coated long stem for osteoporotic unstable intertrochanteric fractures[J]. J Arthroplasty, 2011,26(4):626-632.

胸骨钢丝捆绑与钢板固定大转子方式在不稳定股骨转子间骨折患者人工股骨头置换术中的应用及疗效比较

Comparison of application and curative effects between sternal wire binding and plate fixation of greater trochanter in artificial femoral head replacement of patients with unstable intertrochanteric fracture

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