股骨近端防旋髓内钉与Gamma钉治疗股骨转子间骨折的效果比较

Effect comparision of proximal?femoral nail anti-rotation and Gamma nail treating intertrochanteric fracture

目的 探讨股骨近端防旋髓内钉治疗股骨转子间骨折的临床效果。方法 选择2013年1月~2015年5月我院收治的股骨转子间骨折患者80例,按照随机数字表法分为两组,各40例。对照组使用Gamma钉治疗,观察组采用股骨近端防旋髓内钉治疗,比较两组的手术时间、术中出血量、复位后骨折间隙及骨折愈合时间,并发症发生情况及术后3个月的Harris评分优良率。结果 观察组的手术时间为（45.6±8.5）min,短于对照组的（65.6±10.3）min,术中出血量为（15.8±1.7）ml,少于对照组的（35.6±2.6）ml,骨折间隙为（1.7±0.1）mm,小于对照组的（2.3±0.2）mm（P〈0.05）;观察组的术中股骨干骨折、术后局部肿胀发生率分别为2.5%、5.0%,显著低于对照组的22.5%、25.0%（P〈0.05）,观察组的Harris评分优良率显著高于对照组（P〈0.05）。结论 股骨近端防旋髓内钉治疗股骨转子间骨折创伤小,术后恢复快,并发症少,值得临床推广。

Objective To explore the clinical effect of proximal femoral nail anti-rotation treating intertrochanteric fracture. Methods 80 cases with intertrochanteric fracture treated by our hospital from January 2013 to May 2015 were selected and divided into two groups according to the random number table method,and there were 40 cases in each group.Control group was treated by Gamma nail,while observation group was treated by proximal femoral nail anti-rota- tion.The operative time,blood loss during operation,fracture space after reduction,and fracture healing time,incidence of complication and excellent and good rate of Harris score between two groups was compared respectively. Results The operative time in observation group [（45.6±8.5） min] was was shorter than that of control group [（65.6±10.3） mini,blood loss during operation in the observation group [（15.8±1.7） roll was less than that of control group [（35.6±2.6） ml],frac- ture space [（1.7±0.1） mm] in observation group was smaller than that of control group [（2.3±0.2） mm]（P〈0.05）;incidence rate of intraoperative femoral shaft fracture and local swelling after operation （2.5%,5.0%） in observation group was ob- viously lower than that of control group （22.5%,25.0%） respectively （P〈0.05）,and excellent and good rate of Harris score in observation group was obviously higher than that of control group （P〈0.05）. Conclusion Proximal femoral nail anti-rotation treating intertrochanteric fracture has advantages of less trauma,rapid recovery after operation and fewer complication,so it is worthy of clinical promotion.