股骨转子间骨折不同内固定疗效的比较

Comparisons of effects of internal fixation devices in the treatment of intertrochanteric fractures of femur

目的 探讨股骨转子间骨折内固定物的临床效果。方法 对216 例股骨转子间骨折,采用多枚中空长加压螺钉、鹅头三翼钉、Richard 钉、γ钉4 种内固定器材内固定,并进行临床随访分析。结果 随访半年以上,存活患者199 例骨折全部愈合。据黄公怡关节功能评定标准,优良率分别为:中空长加压螺钉94-9 % 、鹅头三翼钉85-1 % 、Richard 钉93-1 % 、γ钉100 % 。结论 中空长加压螺钉系闭合穿钉内固定,手术创伤少,且内固定牢靠,稳定型骨折及年老体弱者应首选此术式。γ钉为最牢固的内固定,系半闭合手术,手术创伤相对较小,不稳定骨折应首选此术式。

Objective To observe the clinical effect of internal fixation devices in treatment of intertrochanteric fractures of femur. Methods 4 kinds of internal fixation devices including hollow long pressurizing screw, Mc Laughlin nail, Richard screw and γ pin were chosen for treating 216 patients with intertrochanteric fractures of the femur, and the patients were followed up for 6 months. Results 199 survival patients had the fractures united. According to Huang Gongyis standard of joint function, excellent or good results were seen in 94 9%,85 1%,93 1%,100%, respectively. Conclusion Hollow long pressurizing screw is propitious to be used in patients with stable fracture or elderly, debilitated patients because of its solidity and fewer operative trauma. However, γ pin is the most solid internal fixation device and should be firstly chosen in patients with unstable fracture.