人工关节置换与闭合复位Gamma钉治疗股骨粗隆间骨折对比研究

A comparative clinical study of HFR and Gamma nail in the treatment of intertrochanteric fracture of femur

目的:探讨人工股骨头置换(HFR)与Gamma钉治疗老年转子间骨折的疗效与安全性。方法:将211例老年股骨粗隆间骨折患者,根据不同治疗分为FHR组(137例)和Gamma钉组(74例);记录两组手术时间、术中出血量、术后引流量、住院时间;术后7d、6个月及12个月均通过Harris评分评估患者髋关节功能,记录不良反应发生率。结果:HFR组较Gamma钉组手术时间长(P=0.044);术中出血量及术后引流量均较多(P<0.05),住院时间长(P<0.01)。术后7d时HFR组患者较Gamma钉组改善更明显(P<0.05)。Gamma钉组围手术期并发症发生率较高(P=0.007)。结论:虽然HFR手术较Gamma钉手术创伤大,但术后住院时间短、围手术期并发症较少,且更快的改善髋关节功能。

Objective： To evaluate the efficacy and safety of artificial femoral head replacement （HFR） and Gamma nail in the treatment of intertrochanteric fractures in the elderly. Methods ： One hundred and twenty - one patients with intertrochanteric fracture of femur were divided into FHR group （137 cases） and Gamma nail group （74 cases） according to different treatment. The operation time, the patients＇ hip function was evaluated by Harris score at 7 days,6 months and 12 months respectively. The incidence of complication was recorded in both groups. Results ： Comparing to that of Gamma nail group,the operation time of HFR group was longer than that of Gamma nail group（P = 0. 044）,and the bleeding volume and postoperative drainage volume were more （P〈0. 05） and length of hospitalization was longer （P〈0. 0 1 ） . The HFR group improved more significantly than the Gamma nail group at 7 days （P〈0.05） . Gamma nail group of the perioperative and complication rate was higher （P=0.0 0 7 ） . Conclu-sion ： Although HFR is more invasive than Gamma nail surgery, shorter length of hospitalization, fewer perioperative complications,and faster improvement of hip function are in HFR.