Gamma3钉与DHS治疗股骨粗隆间骨折的临床比较

Curative Effect of Gamma 3 and DHS Fixation for Treating Intertrochanteric Fractures of Femur in Elderly Patients

目的 比较和分析Gamma 3钉与动力髋螺钉（dynamic hip screw,DHS）治疗股骨粗隆间骨折的临床效果.方法 回顾性分析2009年1月至2012年1月122 例股骨粗隆间骨折患者病例资料,其中实施Gamma 3钉内固定治疗者60 例（男16 例,女44 例;平均年龄71.8 岁）,采用DHS内固定治疗者62 例（男17 例,女45 例;平均年龄72.1 岁）,两组患者年龄、性别、受伤原因、骨折类型、并发症、围手术期处理、术后治疗等基本情况无明显差异,比较和分析两组患者手术时间、术中失血量、输血量、住院时间、术后并发症、骨折愈合时间及关节功能恢复状况.结果 所有病例均随访6～25个月,平均12.5个月;手术时间、住院时间DHS组显著长于Gamma 3钉组（P＜0.01）;术后并发症DHS组显著高于Gamma 3钉组（P＜0.05）;术后骨折愈合时间DHS显著短于Gamma 3钉组（P＜0.05）,术后髋关节功能良好率两组疗效差异无统计学意义（P＞0.05）.结论 两种手术方法各有优缺点,术前应正确评估患者生理和心理状态及骨折类型,合理地制定手术策略.

Objective To compare the clinical outcomes between Gamma 3 nail and dynamic hip screw （DHS） in the treatment of lntertrochanteric fractures of femur. Methods Retrospective analysis of two cohorts of patients treated with Gam- ma 3 between Jan 2009--Jan 2012（60 cases,16 men and 44 women,with mean age of 71.8 years） versus DHS （62 cases,17 men and 45 women,with mean age of 72.1 years） was performed. The patient demographic data,incidence of lateral wall frac- ture,rehabilitation progress and functional recovery score were recorded and statistically compared Results The average fol- low-up period was 12.5 months （range,6 N 25）. All the fractures healed There were significant differences between Gamma 3 nail group and DHS group in the average operating time and the hospitalization time during surgery （ P 〉 0.05 ） Compared with the group of Gamma 3 nail ,the group of DHS had obvious advantages in terms of fracture healing time ,but had disadvantages in postoperative complications. Conclusion Two operative methods have their own advantages and disadvantages The excel- lent clinical effect can be achieved, if the physical and psychological status of patients are appraised correctly, the types of frac- tures are analyzed exactly, the internal fixation, rehabilitation exercise and the therapy plans are chosen rationally before operations.