股骨转子周围不稳定骨折临床治疗分析

Analysis on Treatment of Unstable Peritrochanteric Fractures

目的探讨股骨转子周围骨折采用Gamma钉和动力髋螺钉(DHS)固定的手术疗效。方法2001-03/2007-03手术治疗59例股骨转子周围骨折患者中,22例使用Gamma钉固定,37例使用DHS固定,对手术资料、术后并发症及髋关节功能进行临床随访分析。结果55例获得随访,随访624个月,平均15个月。所有患者在术后3个月复查X线片均有明显骨痂生长,9个月后所有患者都达到骨折完全愈合。疗效优24例,良25例,可5例,差1例。Gamma钉手术切口长度、术中出血量较DHS手术小,而且患者可早期下床负重而不增加术后并发症发生率。结论Gamma钉手术创伤小,适用性强,是治疗不稳定性转子周围骨折的理想方法之一。

Objective To investigate Gamma nail with DHS in the treatment of peritrochanteric femoral fractures. Methods From March 2001 to March 2007, Fifty nine patients with peritrochanteric fracture were included. The total 22 cases were operated with Gamma nail while 37 cases with DHS . Clinical assessments included operation details, complications and functional recovery of hip joint in the two groups at follow-ups. Results Gamma nail was implanted with a significantly smaller incision and less intra-operative bleeding. The Gamma nail group had an earlier full weight bearing without a higher rate of complication. Conclusion Gamma nail is one of the ideal choices for the treatment of peritrochanteric fractures.