微创髓外固定与髓内固定治疗老年稳定型股骨转子间骨折的效果研究
刘兴国，鱼红进，杨益宏，宋明辉
（西安高新医院骨一科，陕西 西安，710075）
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摘要：
目的 比较微创髓外固定与髓内固定治疗老年稳定型股骨转子间骨折的临床效果。方法 回顾性分析2012 年1 月至2016 年12 月我院78 例老年稳定型转子间骨折患者的临床资料，其中髓外组（40 例）采用微创髓外固定治疗，髓内组（38 例）采用 髓内固定治疗。比较两组患者的手术切口长度、手术时间、术中出血量、骨折间歇及骨折愈合时间，比较两组患者术后1、3、6 个月的髋关节Harris 评分、BADL 评分、住院时间及住院费用。结果 髓外组的切口长度、手术时间及术中出血量均优于髓内 组（P<0.05）；两组骨折间歇、骨折愈合时间比较，差异无统计学意义（P>0.05）。术后3、6 个月，两组患者的Harris 评分及 BADL 评分均升高，差异显著（P<0.05）；髓外组术后1、3 个月Harris 评分及术后1 个月BADL 评分显著高于髓内组（P<0.05）。
髓外组患者的术后住院时间、住院总时间均短于髓内组，术后费用、住院总费用均显著低于髓内组，差异有统计学意义（P<0.05）。结论 微创髓外固定治疗老年稳定型股骨转子间骨折具有创伤小、恢复快、住院时间短、费用低的优点，值得临床推广。
关键词：微创髓外固定；髓内固定；股骨转子间骨折
中图分类号：R687.3文献标志码：A文章编号：2096-1413(2018)01-0007-03
Effect of minimally invasive extramedullary and intramedullary fixation in the treatment of elderly stable femoral
intertrochanteric fractures
LIU Xing-guo, YU Hong-jin, YANG Yi-hong, SONG Ming-hui
(the First Orthopedics Department, Xi``an Gaoxin Hospital, Xi``an 710075, China)
ABSTRACT: Objective To compare the effect of minimally invasive extramedullary and intramedullary fixation in the treatment of elderly stable femoral intertrochanteric fractures. Methods The clinical data of 78 elderly patients with stable intertrochanteric fractures from January 2012 to December 2016 in our hospital were analyzed retrospectively. The extramedullary group (40 cases) was treated with minimally invasive extramedullary fixation, and the intramedullary group (38 cases) was treated with intramedullary fixation. The surgical incision length, operation time, intraoperative blood loss, fracture intermission and fracture healing time were compared, and the Harris hip scores, BADL scores, hospital stay and hospitalization costs were compared between the two groups. Results The incision length, operation time and intraoperative blood loss in the extramedullary group were better than those in the intramedullary group (P<0.05). There were no significant differences in fracture intermission and fracture healing time between the two groups (P>0.05). At 3 and 6 months after operation, the Harris scores and BADL scores increased significantly in both groups (P<0.05). The Harris scores at 1, 3 months after operation and the BADL score at 1 month after operation in the extramedullary group were significantly higher than those in the intramedullary group (P<0.05). The postoperative hospital stay and total hospital stay in the extramedullary group were shorter than those in the intramedullary group, the postoperative cost and the total cost of hospitalization were significantly lower than those in the intramedullary group, the differences were statistically significant (P<0.05). Conclusion Minimally invasive extramedullary fixation for treatment of elderly stable intertrochanteric fractures has the advantages of less trauma, faster recovery, shorter hospital stay and lower cost, which is worthy of clinical promotion.
KEYWORDS: minimally invasive extramedullary fixation; intramedullary fixation; intertrochanteric fractures
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