股骨转子间骨折三种内固定方法的疗效观察  

Effect of surgical treatment of intertrochanteric fractures with three internal fixation methods:a comparative study

作　　者：吴震东[1] 李志杰[2] 

机构地区：[1]浙江温州市解放军第一一八医院骨科,325000 [2]温州医科大学附属第二医院骨科,325027

出　　处：《环球中医药》2013年第S2期21-23,共3页Global Traditional Chinese Medicine

摘　　要：目的对比股骨转子间骨折三种内固定方法的治疗效果,为临床治疗策略的制订提供参考。方法选取我院骨科收治的股骨转子间骨折的90例患者,随机将其分为A组、B组以及C组各30例,A组采用130°角度钢板内固定术进行治疗,B组采用加压滑动鹅头钉内固定术进行治疗,C组采用Gamma钉内固定术进行治疗。对比三组患者的手术出血量、手术时间、住院天数、手术疗效以及术后并发症的发生情况。结果 C组患者的手术出血量、手术时间均显著少于B组和A组,P<0.05;B组患者的手术出血量和手术时间均显著少于A组,P<0.05。C组患者临床疗效优的比例为90.00%(27/30),优良率为100.00%;B组疗效优的比例为53.33%(16/30),优良率为83.33%;A组为43.33(13/30),优良率为73.33%;C组患者优的比例以及优良率均显著高于B组和A组,P<0.05。A组并发症的发生率为56.67%;B组并发症的发生率为36.67%;C组患者没有发生明显的并发症,C组患者并发症的发生率显著低于B组和A组,P<0.05。结论 Gamma钉内固定术治疗股骨转子间骨折的临床疗效良好,且术后并发症少,有利于患者早期康复,值得在临床上进一步推广应用。Objective To compare the effect of three internal fixationMethods for surgical treatment of intertrochanteric fractures and pro-vide new therapeutic strategies in clinical practice .Methods 90 cases of intertrochanteric fractures were randomly divided into A ,B and C three groups with 30 cases in each group .Patients in group A were treated with 130°angle plates ,group B with dynamic hip screws (DHS) and group C with Gamma nails .The volume of intraoperative blood loss ,operative time ,length of stay ,surgical outcomes and postoperative complications were evaluated and compared .Results The intraoperative blood loss and operative time of group C were significantly decreased in comparison with group A and group B ,P<0.05 ;the intraoperative blood loss and operative time of group B were much less than those of group A ,P<0.05 .The excel-lent rate of the three groups was 90% (27/30) in group C with a good to excellent rate of 100% ,53.33% (16/30) in group B with a good to excel-lent rate of 83.33% ,43.33% (13/30) in group C with a good to excellent rate of 73.33% .The excellent rate and good to excellent rate in group C were both significantly higher than those of group B and group A ,both P<0.05 .The occurrence of complications was 56.67% and 36.67% in group A and group B ,respectively ,while no complications occurred in group C .Group C had a much lower complication rate than that of group A and group B ,P<0.05 .Conclusions Gamma nails had better outcomes in the treatment of intertrochanteric fractures with minor complications and early recovery and this treatment modality deserves to be popularized in clinical practice .

关 键 词：股骨转子间骨折 130°角度钢板 加压滑动鹅头钉 GAMMA钉 

分 类 号：R687.3[医药卫生—骨科学]