股骨带锁髓内钉与加长γ钉治疗股骨粗隆下骨折疗效分析

Analysis of Curative Effect of Femoral Interlocking Intramedullary Nail and LengthenedγNail in Treatment of Femoral Subtrochanteric Fracture

目的:通过对股骨带锁髓内钉与加长三代γ钉内固定治疗股骨粗隆下骨折进行分析,比较2种内固定方法的治疗效果。方法:筛选2014年1月~2019年1月分别采用普通股骨髓内钉和加长三代γ钉内固定治疗的137例股骨粗隆下骨折患者。比较2组在手术时间、术中透视时间、术中、后出血量、切口愈合时间、骨折愈合时间、髋关节功能评分等方面的差异。结果:137例患者均获得随访,平均11.3个月。加长三代γ钉组在手术时间、透视时间、术中、后出血量均高于普通股骨髓内钉组,评分差异有统计学意义(P<0.05);但2组病例在切口愈合时间、骨折愈合时间、髋关节功能Sanders评分,差异无统计学意义(P>0.05)。结论:股骨带锁髓内钉与加长三代γ钉在治疗股骨粗隆下骨折时各有优缺点,术者可根据骨折类型及患者病情选择恰当有效的内固定方式。

Objective:To compare the therapeutic effect of two kinds of internal fixation methods by analyzing the treatment of subtrochanteric fracture of femur with interlocking intramedullary nail and lengthened three generations ofγnail.Methods:From January 2014 to January 2019,137 cases of subtrochanteric fracture of femur were treated with common femoral intramedullary nail and lengthened three generation gamma nail respectively.The differences of operation time,intraoperative fluoroscopy time,intraoperative and postoperative bleeding,incision healing time,fracture healing time,hip joint function score between the two groups were compared.Results:All 137 patients were followed up for an average of 11.3 months.The operative time,fluoroscopy time,intraoperative and post-operative blood loss in the three-generation extendedγnail group were higher than those in the ordinary femoral intramedullary nail group,and the score difference was statistically significant(P<0.05);There were no statistically significant differences in healing time and hip joint function Sanders score(P>0.05).Conclusion:There are advantages and disadvantages in the treatment of subtrochanteric fracture of femur with interlocking intramedullary nail and lengthening three generations ofγnail.The operative can choose the appropriate and effective internal fixation according to the type of fracture and the patient’s condition.