MTDHS、DHS及Gamma钉内固定对股骨转子间骨折患者Harris评分的影响

Effect and influence on harris hip score of intertrochanteric fractures by MTDHS,DHS and gamma nail fixation

目的探讨股骨转子间骨折患者应用各种不同内固定方法的治疗效果,并进行对比研究。方法回顾性分析82例股骨转子间骨折患者应用不同内固定方法治疗的临床资料,其中27例应用微创动力髋螺钉(MTDHS)内固定进行治疗,设立为A组。29例应用动力髋螺钉(DHS)内固定进行治疗,设立为B组。26例应用Gamma钉内固定治疗股骨转子间骨折,设立为C组,对比分析各组的手术观察指标及并发症以及对Harris评分的影响。结果 A组手术用时最短,术中出血量最少,且术后患者住院时间最短,术后患者卧床时间最短、术后临床愈合快。A组并发症发生率明显低于B组(χ2=7.324,P<0.05)、C组(χ2=5.673,P<0.05)差异有统计学意义。术后随访1、2年,A组Harris评分优良率明显高于B组、C组,差异有统计学意义(P<0.05)。结论 MTDHS手术时间短、出血量少、术后并发症发生率低,Harris评分优良率高,对于治疗股骨转子间骨折具有很大的优势。

Objective The patients with intertrochanteric fracture fixation methods for a variety of treatment were compared. Methods A retrospective analysis of 82 cases patients with intertrochanteric fracture fixation methods in different clinical data, of which 27 cases of minimally invasive dynamic hip screw （MTDHS） fixation for treatment, setting up for the A group. 29 cases of application of dynamic hip screw （DHS） fixation for treatment, setting up for the B group. 26 Applica- tion of Gamma nail fixation of intertrochanteric fractures, the establishment of group C, group comparative analysis of the observed indicators and complications of surgery, as well as the impact of the Harris score. Results A group operation with the shortest, least amount of blood loss and postoperative hospital stay was the shortest, the shortest postoperative bed, after clinical healing. A group of complications was significantly lower than group B （χ2=7.324, P 〈 0.05）, C group （χ2=5.673, P 〈 0.05）, the difference was statistically significant. 2-year postoperative follow-up, A group of excellent Harris hip score was significantly higher than the B group, C group, the difference was statistically significant （P 〈 0.05）. Conclusion DHS, Gamma nail more, MTDHS shorter operative time, less blood loss, postoperative complication rate is low, Harris score good rate, for the treatment of intertrochanteric fractures with a great advantage.