股骨重建钉和Gamma钉治疗多发性骨软骨瘤患者粗隆间骨折的疗效观察

Efficacy of reconstruction femoral nails and Gamma nails for intertrochanteric fracture in patients with multiple osteochondroma

目的探讨股骨重建钉和Gamma钉治疗多发性骨软骨瘤粗隆间骨折的临床疗效。方法选取2017年1月至2020年6月间榆林市第一医院收治的72例多发性骨软骨瘤粗隆间骨折患者,按照治疗方法不同分为重建钉组37例和Gamma钉组35例,重建钉组患者采用股骨重建钉治疗,Gamma钉组患者采用Gamma钉治疗。采用视觉模拟评分(VAS)、Harris髋关节功能评分量表评估患者疼痛情况和髋关节功能恢复情况,比较两组患者围术期情况和并发症发生情况。结果重建钉组患者手术时间、术中出血量、股骨愈合时间和住院时间均较Gamma钉组少,差异均有统计学意义(均P<0.05)。术前,两组患者疼痛和功能评分无差异。术后,两组患者VAS评分随时间逐渐降低,且重建钉组均更低于Gamma钉组;两组患者Harris评分随时间逐渐升高,且重建钉组均更高于Gamma钉组,差异均有统计学意义(均P<0.05)。重建钉组患者并发症发生率为16.2%,Gamma钉组为11.4%,两组比较,差异无统计学意义(P>0.05)。结论与Gamma钉治疗相比,股骨重建钉治疗多发性骨软骨瘤粗隆间骨折手术操作更简单,术中出血量较少,疼痛较小,且髋关节功能恢复更快,但二者安全性相当。

Objective To compare the efficacy of reconstruction femoral nails and Gamma nails in the treatment of intertrochanteric fractures in patients with multiple osteochondroma.Methods A total of 72 patients with multiple osteochondroma complicated with intertrochanteric fractures diagnosed and treated at Yulin First Hospital from January 2017 to June 2020 were selected.They were categorized into a reconstruction nail group(37 patients)and a Gamma nail group(35 patients)based on the therapy they received.Patients in the reconstruction nail group received treatment with reconstruction femoral nails and patients in the Gamma nail group received treatment with Gamma nails.Visual analogue scale(VAS)and Harris hip joint function score scale were used to evaluate pain and hip function recovery.The perioperative status and incidence of complications were compared between the two groups.Results The duration of operation,intraoperative blood loss,time to femoral healing and length of hospital stay were significantly lower in the reconstruction nail group than in the Gamma nail group(all P<0.05).There was no significant difference in pain and function between the two groups before the surgery(P>0.05).After the surgery,VAS scores decreased over time and the scores were lower in the reconstruction nail group than in the Gamma nail group(all P<0.05).Harris scores increased over time and the scores were higher in the reconstruction nail group than in the Gamma nail group(all P<0.05).The incidence of complication rate was 16.2%in the reconstruction nail group and 11.4%in the Gamma nail group(P>0.05).Conclusion Compared with the treatment with Gamma nails,the treatment with reconstruction femoral nails is simple with little intraoperative blood loss,mild pain and fast recovery of hip function for multiple osteochondroma complicated with intertrochanteric fractures.The safety was comparable.