不同手术方式治疗143例股骨粗隆间骨折的疗效分析

Curative Effect Analysis of the Treatment of Femoral Intertroehanteric Fracture with Different Operation Methods (Reports of 143 cases)

目的探讨动力髋螺钉(DHS)、股骨近端髓内钉(PFN)、Gamma钉在治疗股骨粗隆间骨折治疗中的疗效。方法对143例分别接受了DHS、PFN、Gamma钉内固定手术的股骨粗隆间骨折患者进行回顾性研究,平均随访24个月,对临床各观察指标、临床疗效及术后并发症发生率等进行观察。结果各临床指标中,Gamma组和PFN组的手术时间、术中出血量、术后引流量、下地负重时间等均低于DHS组(P<0.01);髋关节功能评分优良率,DHS组80.4%%、Gamma钉组95.6%、PFN组76.2%,术后并发症发生率分别为14.3%、4.4%、9.5%。结论各种固定各有其自身特点,Gamma钉是治疗各类型股骨粗隆间骨折较为理想的固定方式,尤其适用于骨质疏松的高龄粗隆间骨折、不稳定型骨折和合并症较多的患者。

Objective To explore the treatment effect of dynamic hip screw （DHS）, proximal femoral nail（PFN）, Gamma nail, three internal fi xation in the femoral intertrochanteric fracture. Method 143 cases of intertroehanteric fractures were accepted internal fi xations of DHS, PFN, and Gamma, and followed-up 24 months in average. Then collected each clinical indexes were collected, curative effect and postoperative complications incidence rates. Result In the clinical indexes, operation time, hemorrhage volume in operation, drainage volume after operation in Gamma group and PFN group were much lower or shorter than DHS group. Hip joint function score of three groups of DHS, Gamma and PFN were 80.4%, 95.6%, and 76.2% respectively, and the postoperative complications incidence rate were 14.3%, 4.4% and 9.54% respectively. Conclusion Each way has its owe benefi t. Ganmma nail group shew ideal internal fi xation for the treatment of all kind of femoral intertrochanteric fractures,especially for osteoprosis, unstable intertrachanteric fractures,and cases associated with much other diseases.