Gamma 3型髓内钉内固定治疗老年股骨粗隆间骨折76例分析

Analysis of Gamma 3 intramedullary nail in treatment of femoral intertrochanteric fracture in 76 elderly patients

目的评估Gamma3型髓内钉内固定治疗老年股骨粗隆间骨折的临床效果。方法自2010—01—2012—12采用Gamma3型髓内钉内固定治疗老年（年龄〉65岁）St骨粗隆间骨折76例，并进行随访分析。结果1例于术后40d因呼吸衰竭死亡，余75例均获得随访6—24个月，平均15个月。随访患者骨折均愈合，愈合时间10-18周，平均14周。其中2例分别出现8°、10°髋内翻畸形，1例术后1年因内科疾病死亡。术后疗效根据髋关节功能Harris评分标准评定：优37例，良31例，可5例，差2例，优良率90．7％。结论Gamma3型髓内钉内固定治疗老年股骨粗隆间骨折具有手术创伤小、手术时间短、固定牢固、术后并发症少等优点，是治疗股骨粗隆间骨折的理想内固定物。

Objective To evaluate the clinical effect of Gamma 3 intramedullary nail in the treatment of femoral inter- trochanteric fracture in the elderly patients. Methods A total of 76 patients（65 years or older） with femoral intertrochanteric fracture who were treated by Gamma 3 intramedullary nail in our department between Jan. 2010 and Dec. 2012 were selected and follow-up analysis was performed. Results One patient died of respiratory failure 40 days after surgery. Other 75 patients were all followed-up with fractures healed ,the mean follow-up was 15 months （range 6-24 months）and average time to fracture union was 14 weeks （range 10-18 weeks）. Among them,2 cases respectively had 8° and 10° hip varus deformity, and one patient died due to internal medicine diseases 1 year after surgery.According to Harris scoring criteria,the outcome was excellent in 37 cases,preferabe in 31 ,good in 5 and poor in 2, with excellent and good rate of 90.7%. Conclusion Gamma 3 intramedullary nail for treatment of senile femoral intertrochanteric fractures has advantages of smaller surgical trauma,shorter operation time,firm f＇Lxation and less postoperative complications. It is the ideal fLxation in the treatment of femoral intertrochanteric fractures.