Gamma钉治疗股骨转子间骨折远端是否锁钉疗效比较

Comparison efficacy of Gamma nail in the treatment of femoral intertrochanteric fractures with and without distal locking screw

目的探讨Gamma钉内固定治疗股骨转子间骨折远端是否锁钉对疗效的影响。方法对144例稳定性股骨转子间骨折患者采用Gamma钉内固定,根据远端锁钉与否将患者分为远端未采用锁钉组(非锁钉组,70例)和远端采用锁钉组(锁钉组,74例)。观察两组患者手术时间、透视时间、输血量、住院时间、骨折复位质量、骨折愈合时间及并发症。结果两组均获得12个月随访。两组骨折复位质量、住院时间、骨折愈合时间比较差异无统计学意义(P>0.05)。手术时间、术中透视时间、输血量锁钉组明显长(多)于非锁钉组(P<0.001)。两组患者并发症发生率比较差异无统计学意义(P>0.05)。结论采用Gamma钉治疗稳定性股骨转子间骨折远端可以不行锁钉固定,不影响骨折愈合和临床疗效,还具有减少透视时间、手术时间、术后并发症等优点。

Objective To investigate the effect of whether adopting distal locking screw on femoral intertrochanteric fractures treated with Gamma nailing.Methods The 144 patients with stable intertrochanteric fractures were divided to Gamma nailing without distal locking screw for intertrochanteric fractures(unlocked group,70 cases)and Gamma nailing with distal locking screw for intertrochanteric fractures(locked group,74 cases).The following data were recorded,including operative time,fluoroscopy time,volume of blood transfusion,length of hospital stay,quality of fracture reduction,time of fracture healing,and complications.Results All patients were followed up for 12 months.There were no significant differences between the two groups in the quality of fracture reduction,length of hospital stay,and time of fracture healing(P>0.05).The volume of blood transfusion,operation time,and fluoroscopy time in the locked group were significantly higher than those in the unlocked group(P<0.001).The difference in the incidence of complications between the two groups was not statistically significant(P>0.05).Conclusions The Gamma nails for the treatment of stable intertrochanteric fractures,the absence of distal locking screw does not affect bone healing and clinical outcomes.It has the advantages of reducing fluoroscopy time,operation time,and postoperative complications.