不同方法治疗股骨转子间骨折的疗效比较

The comparison of three different methods in the treatment of femoral intertrochanteric fracture

目的比较微创动力髋螺钉（MTDHS）、动力髋螺钉（DHS）及Gamma钉固定治疗股骨转子间骨折的效果,探讨老年股骨转子间骨折的合理治疗方法。方法对61例高龄股骨转子间骨折患者采用了3种不同治疗方法：MTDHS组22例,DHS组20例,Gamma钉组19例,对手术时间、出血量和髋关节功能进行评价。结果 58例获随访,时间8~19（13±2.8）个月,1例失访,2例死亡。髋关节功能按Harris评分标准进行评定：MT-DHS组83~91（89.75±4.05）分,DHS组69~80（76.36±5.27）分,Gamma钉组75~84（82.57±3.28）分。MTDHS组在手术时间、出血量和髋关节优良率方面均优于DHS组及Gamma钉组（P〈0.01）。结论 MTDHS治疗股骨转子间骨折,手术操作微创,组织创伤小,术后髋关节功能恢复好,并发症发生率低,是治疗转子间骨折的较好方法。

Objective To discuss the clinical effect of micro-trauma dynamic hip express screw（MTDHS）,dynamic hip screw（DHS） and Gamma nail for femoral intertrochanteric fracture in aged patient.Methods 61 cases with femoral intertrochanteric fractures were treated by MTDHS（22 cases）,DHS（20 cases） and Gamma nail（19 cases）.The operation time,amount of bleeding and postoperative function of hip were evaluated.Results 58 patients were followed up for 8~19（13±2.8） months,1 case was lost,2 cases were dead.Functional restoration of Harris showed that MTDHS group was 83~91（89.75±4.05） points,DHS group was 69~80（76.36±5.27） points,and Gamma nail group was 75~84（89.75±4.05） points.MTDHS group were better than other two groups on operation time,amount of bleeding,hip function（P0.01）.Conclusions The internal fixation of MTDHS is a good choice for treating femoral intertrochanteric fracture.The operation is minimal,less injury to the soft tissue,the recovery of hip joint function is better,the incidence of complications is less in MTDHS group than DHS group.