动力髋螺钉、股骨近端锁定钢板、Gamma钉治疗老年股骨转子间骨折疗效分析

Dynamic Hip Screw,A Locking Proximal Femoral Plate,Gamma Nail TreatmentAged Intertrochanteric Fracture of Femur

目的:比较动力髋螺钉(DHS)、股骨近端锁定钢板(LCP)、Gamma钉治疗老年股骨转子间骨折疗效分析。方法:对132例75岁以上股骨粗隆骨折病人分别使用动力髋螺钉、股骨近端锁定钢板、Gamma钉治疗手术时间、出血量、住院时间、骨折愈合时间、疗效、并发症。结果:本组47例行动力髋螺钉、42例行股骨近端锁定钢板、43例行Gamma钉治疗,Gamma钉组平均手术时间82.24 min,长于DHS组和股骨近端锁定钢板(P<0.05),股骨近端锁定钢板组时间最短(P<0.05)。Gamma组出血量最多(P<0.05),股骨近端锁定钢板组组最少(P<0.05)。住院时间和骨折愈合时间3组差异无显著性意义(P>0.05)。疗效、并发症3组差异无显著性意义。结论:3种固定物均可以有效地用于老年股骨转子间骨折的治疗。临床工作中应根据骨折类型、固定物的特点及患者的身体状况选择做出最佳选择。

Objective：Comparison of dynamic hip screw（DHS）,proximal femoral locking plate（LCP）,Gamma nail in treatment of aged intertrochanteric fracture of femur.Methods：In 132 patients over 75 years old patients with femoral intertrochanteric fracture with dynamic hip screw,a locking proximal femoral plate,Gamma nail for the treatment of operation time,bleeding volume,duration of hospitalization,fracture healing time,efficacy,complications.Results：This group of 47 cases,42 cases with dynamic hip screw locking proximal femoral plate,43 cases with Gamma nail treatment,Gamma nail group mean operation time 82.24 min,than the DHS group and the proximal femoral locking plate（P 0.05）,proximal femoral locking plate group in the shortest time（P〈0.05）.Maximum amount of bleeding in Gamma group（P〈0.05）,proximal femoral locking plate group（P〈0.05） minimum.The hospitalization time and healing time of 3 no significant difference between groups（P〈0.05）.efficacy,complications of the 3 groups had no significant difference in meaning.Conclusions：3 kinds of fixtures can be effectively used for the treatment of intertrochanteric fractures in the elderly.Clinical work should according to the type of fracture,fixation and the patient′s physical condition to choose the best choice.