Gamma 3型髓内钉和动力髋螺钉内固定治疗高龄股骨粗隆间骨折的临床研究

Clinical study of Gamma 3 intramedullary nail and dynamic hip screw(DHS) system in treatment of femoral intertrochanteric fracture of elderly

目的探讨Gamma 3型髓内钉(Gamma 3钉)和动力髋螺钉(DHS)内固定治疗高龄股骨粗隆间骨折的临床效果。方法对82例高龄(年龄大于75岁)股骨粗隆间骨折采用手术治疗,其中44例采用Gamma 3钉内固定(Gamma 3钉组),38例采用DHS内固定(DHS组)。比较两组手术时间、术中出血量、术前和术后1周肌酸激酶、术后髋关节Harris评分。结果 Gamma 3钉组平均手术时间、术中出血量、术后7 d血清肌酸激酶含量较DHS组低,差异有统计学意义(P<0.05)。Gamma 3钉组术后1周、6个月Harris评分较DHS组高,但术后12个月两组差异无统计学意义(P>0.05)。结论Gamma 3钉较DHS在内固定治疗高龄股骨粗隆间骨折时具有手术时间短、出血少、创伤小、术后短期恢复快的优点。两种内固定术后都能够获得良好的骨折愈合和远期临床治疗效果。

Objective To estimate the clinical effect of Gamma 3 intramedullary nail and dynamic hip screw （DHS） system in treatment of the aged femoral intertrochanteric fracture. Methods A total of 82 femoral intertrochanteric fracture cases （all were older than 75 years old） were treated by surgical treatment. Forty four patients were treated with Gamma 3 intrameduliary nail （Gamma 3 group） and 38 patients were treated with DHS （DHS group）. Two groups were compared in operation time, intraoperative amount of bleeding, preoperative and postoperative 1 week ereatine kinase （CK）, Harris hip score. Results The operation time, amount of bleeding and 7 days postoperative serum creatine kinase content were less in Gamma 3 group than in DHS group. There was statistical significant differences between the two groups （P 〈0.05）. The Harris score was higher in Gamma 3 group than in DHS group at postoperative I week and 6 months. The Harris score was the same at postoperative 12 months （P 〉0.05）. Conclusion Gamma 3 intramedullary nail has the advantages of shorter operation time, less bleeding, fewer traumas and quicker recovery in the treatment of intertrochanteric fractures of the aged patients compared with DHS. Both systems can get good fracture heating and long-term clinical effect.