股骨近端直型髓内钉对股骨前侧皮质撞击的影响及进针点的选择
《创伤外科杂志》[ISSN:/CN:]
- 期数:
- 2018年10期
- 页码:
- 753-756
- 栏目:
- 临床研究论著
- 出版日期:
- 2018-10-15
文章信息/Info
- Title:
- Impact of proximal femoral nail on the anterior femoral cortex impingement and the choice of needle insertion point
- 文章编号:
- 1009-4237(2018)10-0753-04
- Author(s):
- WANG Hao; FANG Shi-Yuan; WANG Xu-jin; XU Lei; YANG Jia-zhao; LIU Lei
- Department of Orthopedics,Anhui Provincial Hospital,AnHui Medical University,Hefei 230001,China
- 分类号:
- R683.42
- DOI:
- 10.3969/j.issn.1009-4237.2018.10.008
- 文献标识码:
- A
- 摘要:
- 目的 分析股骨近端直型髓内钉对股骨前侧方皮质撞击的影响因素,寻求相对理想的髓内钉入针点。方法 2010年1月—2016年12月安徽医科大学附属省立医院创伤骨科收治180例行股骨近端髓内钉患者,其中男性65例,女性115例; 年龄59～92岁,平均72.2岁。由3位骨科医生通过医学影像存档与通信系统(picture archiving & communication system,PACS)将股骨侧位片放大6倍观察髓内钉钉尖与股骨前侧皮质接触即定义为撞击。记录患者性别、年龄、股骨前弓角、BMI,并对撞击患者的上述数据进行多元回归分析,同时在股骨侧位片上将股骨近端分成前、中、后3等份,观察髓内钉轴线所在位置并比较差异性。结果 180例股骨近端髓内钉中,出现撞击106例(撞击率58.8%); 其中男性31例,女性75例; 年龄65～92岁,平均73.4岁; 股骨前弓角(12.1±1.4)°,BMI(33.6±1.8)kg/m2; 回归分析提示与前侧皮质撞击有关的因素包括性别、年龄、BMI和前弓角。股骨近端进针点前1/3的撞击发生率23.8%,低于中1/3(66.1%)以及后1/3(84.6%)的发生率。结论 老年女性通常合并较大的股骨前弓角,较大的前弓角是导致髓内钉与股骨皮质撞击危险因素,临床上对股骨前弓角较大者应尽量避免选用短直钉。在进针点上应在股骨近端的前侧1/3,而非传统的中后1/3。
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备注/Memo
- 备注/Memo:
- 基金项目: 安徽省公益性技术应用研究联动计划项目(1401045022)
通信作者: 方诗元,E-mail:441083598@qq.com
