股骨粗隆间骨折的微创治疗

Minimally invasive treatment of intertrochanteric fracture

目的探讨微创治疗股骨粗隆间骨折的手术疗效及并发症。方法对2006年1月-2008年9月收治的84例股骨粗隆间骨折进行闭合复位,38例采用Gamm a-3髓内钉固定,46例采用股骨近端髓内钉（PFN）固定。随访6-12个月,骨折临床愈合后,患髋行Harris髋关节功能评分。结果84例骨折全部愈合,愈合时间3-6个月,未发生螺钉切割出股骨头颈、髋内翻畸形、切口深部感染等严重并发症。患肢髋关节功能评定：Gamm a-3固定优良率为89.4%,PFN固定为86.9%。结论采用Gamm a-3髓内钉和PFN微创治疗股骨粗隆间骨折,疗效可靠,并发症少,创伤小,值得临床推广使用。

Objective To investigate the efficiency and complication of minimally invasive treatment for intertrochanteric fracture using Gamma-3 or PFN nail. Methods Since Jan. 2006 to Sep. 2008,84 cases of intertrochanteric fracture were adopted closed reduction and fixed with Gamma-3 or PFN nail. All the patients were followed up for 6 - 12 months. After the fracture healed clinically,the hip function was evaluated according to the Harris criteria. Results All the fractures healed in 84 cases. The fracture-healing time was 3 -6 months. No severe complication occurred including cuts-out of femur head by screws, varus hip, and infection of deep incision. About 89.4% of 38 cases fixed by Gamma-3 and 86.9% of 46 cases fixed by PFN achieved good or excellent hip function. Conclusion Closed reduction and fixation with Gamma-3 or PFN nail are safe and effective for treatment of intertrochanterie fracture.