[Feasibility study of Kirschner wire-fixation-cortical bone technique in treatment of intertrochanteric fracture].

目的: 探讨经骨皮质临时固定技术在不稳定型顺向股骨转子间骨折术中维持复位的可行性及有效性。. Methods: Forty patients with intertrochanteric fracture [AO/Orthopaedic Trauma Association (AO/OTA) type 31-A2.2] admitted between May 2015 and January 2017 and requiring closed reduction and proximal femoral nail antirotation (PFNA) were randomly divided into trial group (intraoperative Kirschner wire-fixation-cortical bone technique group, 20 cases) and control group (conventional treatment group, 20 cases). There was no significant difference in general data of gender, age, side, body mass index, cause of injury, time from injury to operation between the two groups ( P>0.05). The operation time, intraoperative blood loss, and intraoperative fluoroscopy times of the two groups were recorded; the reduction quality of fracture was observed according to the corresponding relationship between medial and anterior cortex (positive, neutral, and negative support) of intraoperative fluoroscopy proposed by ZHANG Shimin, and the stability of internal fixation and fracture healing were observed; Harris score was used to evaluate the recovery of hip function at 12 months after operation. 结果: 试验组术中 2 枚克氏针共植入次数≤4 次 6 例（30%），5～8 次 7 例（35%），≥9 次 7 例（35%）。两组患者手术时间及术中出血量比较差异无统计学意义（ P>0.05），但试验组输血量及术中透视次数均显著少于对照组（ P<0.05）。两组患者均获随访，随访时间 13～21 个月，平均 17 个月。术后无切口感染、下肢深静脉血栓形成、再骨折等并发症以及内固定相关并发症发生。试验组术中复位质量显著优于对照组（ Z=–2.794， P=0.024）。术后 12 个月试验组 Harris 评分显著优于对照组，差异有统计学意义（ t=2.98， P=0.01）。. 结论: 股骨转子间骨折闭合复位 PFNA 内固定术中使用经骨皮质临时固定技术，可在术中有效维持复位效果，减少术者透视次数，提高复位质量，减少异体血输入，获得更好的髋关节功能，且不增加手术时间和术中出血量。.