体表定位Gamma3型髓内钉内固定治疗高龄股骨粗隆间骨折临床疗效

Gamma 3 intramedullary nail combined with body surface localization for treatment of femoral intertrochanteric fractures in aged patients

目的探讨体表定位Gamma3型髓内钉内固定治疗高龄股骨粗隆间骨折的临床疗效。方法回顾性分析自2009-01-2012—0546例高龄股骨粗隆间骨折的临床资料，骨折闭合复位后采用体表定位，置人史塞克公司Gamma3型髓内钉内固定治疗。结果术后并发下肢静脉血栓1例，经溶栓、抗凝、扩血管等治疗后痊愈。术后均获随访12-18个月．平均13．6个月。摄X线片显示骨折均愈合，未发生内固定物松动及脱出，无骨折移位。术后6个月骨折全部愈合，平均愈合时间为12周。临床疗效按髋关节功能Hanis评分标准评定：优30例，良13例，可2例，差1例，优良率93．5％。结论Gamina3．型髓内钉结合体表定位内固定治疗高龄股骨粗隆间骨折具有创伤小、操作简单、手术时间短、生物学固定可靠、可早期下床活动、并发症少等优点，是一种安全、可靠、有效的内固定方式，值得临床推广应用。

Objective To investigate therapeutic effect of Gamma 3 intrameduUary nailing combined with body surface localization in intertroehanterie fracture of femur in aged patients. Methods A total of 46 patients with femoral intertrochanterie fractures were reviewed from January 2009 to May 2012 in our department The patients were treated by dosed reduction Gamma 3 intramedullary nail combined with body surface localization. Results In 46 patients, one had deep vein thrombosis postoperatively, and was cured by thrombolysis, anticoagulation, vasodilators. All patients were followed up for 12-18 months, with an average follow-up time of 13.6 months. X-ray showed all fractures healed. There were no internal fixation loosening and prolapse, no fracture displacement, after six months. The average fracture healing time was 12 weeks. According to Harris score, the outcome was excellent in 30 eases,good in 13,fair in 2 and poor in 1,with excellent and good rate of 93.5%. Conclusion Gamma 3 intramedullary nail combined with body surface localization for treatment for femoral intertroehanterie fracture has advantages such as small trauma,reliable fixation, short time of operation, less complication, earlier health recovery. It is a safe,reliable and effective internal fixation, and has good clinical application.