DHS与Gamma钉治疗老年股骨粗隆间骨折疗效比较

Curative efficacy of DHS and Gamma nail for treating intertrochanteric fracture of the femur in the elderly

目的分析动力髋螺钉(dynamic hip screw,DHS)和Gamma钉在老年股骨粗隆间骨折中的治疗选择和临床疗效。方法对70例老年股骨粗隆间骨折分别行手术治疗,其中DHS内固定49例,Gamma钉内固定21例。比较两组术中和术后多项相关指标(如手术时间、切口长度、术中出血量、术后引流量、X线暴露次数等),并行统计学分析。结果Gamma钉组与DHS组相比较术中出血量、切口长度差异均具有显著性(P<0.05);Gamma钉组与DHS组相比较在手术中X线暴露次数增多(P<0.05);而Gamma钉组与DHS组术后引流量、骨折愈合时间、手术时间比较差异无显著性(P>0.05)。结论只要适应证掌握得当,合理选择内固定,手术操作规范,DHS和Gamma钉治疗老年股骨粗隆间骨折均可以获得相同良好的临床效果,而Gamma钉手术创伤较小,更适用于高龄患者。

Objective To compare the clinical effectiveness of Gamma nail and dynamic hip screw（DHS）for intertrochanteric fractures of the femur in the elderly.Methods Seventy old patients with intertrochanteric fractures undergoing surgical treatment were enrolled.Of 70 patients,49 patients were fixed with DHS（DHS group）,and 21 patients with Gamma nail（Gamma group）.The intraoperative and postoperative relevant indices were compared and analyzed between 2 groups.Results The operative bleeding and incision length showed significant difference between Gamma nail group and DHS group（P0.05）.Compared with DHS group,X ray exposure number increased during operation in Gamma nail group（P0.05）.There was no significant difference in postoperative drainage quantity,operation time and fracture healing time between Gamma nail group and DHS group.Conclusion Gamma nail for intertrochanteric fractures can obtain the same good clinical efficacy as DHS when indications are well directed,and reasonable selection of internal fixation and rational operation are performed.But Gamma nail is more applicable to the elderly patients with small surgical trauma.