关键词: 截石位, 仰卧位, 侧卧位, 股骨粗隆间骨折, 髋关节功能, 并发症

Abstract: Objective  To explore the efficacy of three surgical postures in the treatment of traumatic femoral intertrochanteric fractures. Methods 98 patients with traumatic femoral intertrochanteric fracture treated in our hospital from February 2017 to June 2020 were selected.According to different surgical positions,they were divided into lithotomy position group(33 cases),supine position group(33 cases) and lateral position group(32 cases).The three groups were treated with Asian proximal femoral anti rotation intramedullary nail.The operation related indexes,excellent and good rate of hip function,pain,anxiety and complications were compared. Results There was no significant difference in intraoperative bleeding and fracture healing time among the three groups(P>0.05).The placement time,operation time and fluoroscopy time of lithotomy position group were shorter than those of Supine position group and lateral lying position group(P<0.05).During the follow-up at 6 months after operation,the excellent and good rate in the lateral position group(90.63%) was higher than that in the lithotomy group(84.85%) and supine group(72.73%),but there was no significant difference among the three groups(P>0.05).Compared with the same group before operation, the VAS scores of the three groups were significantly improved at 3 days and 6 months after operation (P<0.05). There was no significant difference in VAS scores before and after operation among the three groups (P>0.05).However,  the score of Amsterdam Preoperative Anxiety and Information Scale (APAIS score) of the three groups had statistical significance in 30 minutes (P<0.05), and the supine position group and lateral position group were higher than the lithotomy position group (P<0.05).The short-term complications in the three groups were 6.06%,9.09% and 6.06%,respectively,and the long-term complications were 3.03%,6.06% and 3.13%,respectively.There was no significant difference in the short-term and long-term complications among the three groups(P>0.05). Conclusion Lithotomy position,Supine position and lateral decubitus position are effective in the treatment of traumatic femoral intertrochanteric fracture,with better recovery of hip function,less pain and fewer complications.However,the lithotomy position is helpful to reduce the injury to doctors and patients and patients' anxiety caused by repeated fluoroscopy,so as to shorten the operation time.

Key words: ithotomy position, supine position, lateral position, intertrochanteric fracture of femur, hip function, complication