Gamma钉与锁定接骨板治疗外侧壁损伤的股骨转子间骨折的疗效分析

目的探究Gamma钉和锁定接骨板内固定治疗外侧壁损伤的股骨转子间骨折的临床疗效.方法纳入66例外侧壁损伤的股骨转子间骨折患者,根据手术治疗方法分为对照组(微创锁定钢板内固定,35例)和观察组(Gamma钉内固定,31例).评估手术时间、术中失血量、住院时间、术后负重时间、愈合时间、并发症、疼痛VAS评分和髋关节Harris功能情况.结果观察组的手术时间、术中失血量、术后负重时间和愈合时间均低于对照组,组间比较差异有统计学意义(P<0.05).住院时间方面,观察组略低于对照组,但是组间比较差异无统计学意义(P>0.05).术后1个月、3个月随访情况:观察组VAS评分明显低于对照组(P<0.05),观察组Harris评分高于对照组(P<0.05).术后6个月随访情况:观察组的AOFAS评分和VAS评分与对照组比较,组间差异无统计学意义(P>0.05).观察组并发症发生率7.3%,低于对照组15.6%,组间比较差异有统计学意义(P<0.05).结论Gamma钉内固定治疗外侧壁损伤的股骨转子间骨折创伤小、恢复快,具有明显优势,值得临床广泛推广.

Objective To explore the clinical effect difference of femoral intertrochanteric fracture with lateral wall fracture treated by Gamma nail and lock plate internal fixation.Methods Patients with femoral intertrochanteric fracture with lateral wall fracture were included in our study.All the patients were assigned into two groups(31 cases in experiment group and 35 cases in control group),which were receive Gamma nail and lock plate internal fixation.Some parameters like surgical time,intraoperative blood loss,impatient time,full bearing standing time,healing time,complication rate,VAS score and Harris score were evaluated.Results For the surgical time,intraoperative blood loss,fiill bearing standing time and healing time aspect,the value of experimental group were lower than control group,there was significant difference between them(P<0.05).The impatient time of experimental group was lower than control group,but there was no significant difference between them(P>0.05).The VAS score and Harris score of patient ini and 3 months had advantage than patients in control group,there was significant difference between above two groups.But,for VAS score and Harris score in 6 months,there was no significant difference between them.Conclusion Gamma nail internal fixation has disadvantage of less invasions than lock plate internal fixation,which has better clinical effect.