DHS及Gamma钉治疗老年人股骨转子间骨折效果分析

Treatment of Intertrochanteric Fractures in Aged Patients with Gamma Nails or Dynamic Hip Screws

目的分析动力髋螺钉(DHS)及Gamma钉治疗老年人股骨转子间骨折的效果。方法85例60岁以上股骨转子间骨折行手术治疗,采用DHS内固定37例,Gamma内固定48例。分析疗效并对两种方法的治疗效果、并发症发生率进行比较。结果本组85中69例下肢功能恢复满意,优良率达81.2%。DHS组的优良率为73.7%,Gamma钉组为89.4%。二者的手术时间、切口长度、出血量和并发症发生率分别为(65.8±18.4)(、86.2±26.5)min;(18.6±6.1)(、11.3±4.7)cm;(0.67±0.16)(、0.56±0.23)L;36.8%、21.3%;其中手术时间、切口长度有显著性差异(P<0.05),而出血量、并发症发生率等无显著性差异(P>0.05)。结论采用DHS及Gamma钉治疗老年人股骨转子间骨折是安全有效的方法,对合并症多的老年病人首选DHS,而对严重粉碎性骨折Gamma钉更为合适。

Objective To analysis the effects of Gamma nails and dynamic hip screws（DHS） in the treatment of intertroehanterie fractures of elderly patients. Methods 85 patients aged over 60 years suffered from intertrochanterie fractures were retrospectively analyzed. Out of the 85 eases, 38 eases were treated with DHS, and the other 47 eases were fixed with Gamma nails. The curative effects and complications were compared simultaneously. Results The functions of lower limbs of 69 patients had recovered satisfactorily,and the total excellent rate was 81.2% in this group,the rates of DHS and Gamma group were 73.7% and 89.4% respectively.The operation time,incision length, bleeding amount,incidence rates of complications of DHS and Gamma nail group were（65.8 ± 18.4） and （86.2 ＋ 26.5） min,（18.6±6.1） and （11.3＋_4.7）cm,（0.67±0.16） and （0.56±0.23）L,36.8% and 21.3% respectively. Conclusion Treatment of intertroehanterie fractures of elders with DHS or Gamma nails are effective and safe methods with the advantages of lesser complications and lower mortality rate to aged patients.To decrease the risk in operation,it is a safe and effective way to use DHS rather than Gamma nail in patients with more complicating diseases. But Gamma nails are more adequate to severely eomminuted fractures.