改良Richards钉治疗股骨转子间粉碎性骨折  

The clinical study of the modified Richards nail treating femoral intertrochanteric comminuted fractures

作　　者：傅宏[1] 吕一 胡钢锋 洪林 俞鹏征 范明君 朱立华 徐国坤 王文艳 

机构地区：[1]萧山区第一人民医院骨科,杭州311200 [2]萧山区中医骨伤科医院骨伤科

出　　处：《中华骨科杂志》2006年第9期582-585,共4页Chinese Journal of Orthopaedics

摘　　要：目的探讨使用改良Richards钉治疗股骨转子间粉碎性骨折的疗效。方法2002年3月至2005年3月,治疗股骨转子间粉碎性骨折69例。随机将其分为两组进行治疗。一组采用改良Richards钉治疗,为试验组,共34例,男18例,女16例;年龄61～78岁,平均67.5岁;左侧21例,右侧13例;按Evan分型,Ⅲ型24例,Ⅳ型10例。另一组采用动力髋螺钉治疗,为对照组,共35例,男19例,女16例;年龄61～80岁,平均65.9岁;左侧19例,右侧16例;Evan分型,Ⅲ型25例,Ⅳ型10例。结果试验组随访时间9～23个月,平均(11.60±3.78)个月;对照组随访时间9～24个月,平均(11.40±4.12)个月。骨折平均愈合时间:试验组为(3.65±0.97)个月,对照组为(4.32±1.38)个月。术后9个月,试验组股骨患侧较健侧平均缩短(0.82±0.36)cm,对照组股骨患侧较健侧平均缩短(1.08±0.51)cm。试验组优良率为94.1%,对照组优良率为71.4%。结论改良Richards钉治疗股骨转子间粉碎性骨折具有较好疗效,可预防发生骨不连及各种畸形愈合。Objective To evaluate the clinical results using modified Richards nail treating femoral intertrochanteric comminuted fractures. Methods From March 2002 to March 2005, 69 patients suffered from femoral intertrochanteric comminuted fractures belong to Evan Ⅲ type or Ⅳ type were randomly divided into experimental group and control group. The experimental group was treated with modified Richards nail, including 34 patients, 18 males and 16 females. The patients were from 61 to 78 years old, and the mean age was 67.5 years old. In this group, 21 patients were involved in left femoral intertrochanteric comminuted fractures, 13 patients were involved in right. The pattern of the fractures included Evan Ⅲ type in 24 cases and Ⅳ type in 10 cases. The control group including 35 patients was treated with DHS, and there were 19 males and 16 females with an average age of 65.9 years （ranged 61 to 80 years）. In this group, 19 patients were involved in left femoral intertrochanteric comminuted fractures, 16 patients were involved in right. The pattern of the fractures included Evan Ⅲ type in 25 cases and Ⅳ type in 10 cases. Results The experimental group were followed-up 9-23 months with a mean of 11.60±3.78 months. The control group were followed-up 9-24 months with a mean of 11.40±4.12 months. In experimental group, the average fracture healing time was 3.65±0.97 months. While in the control group, the average fracture healing time was 4.32±1.38 months. In experimental group, the leg length measured at the 9th month post-operatively was averagely （0.82±0.36） cm shorter in the diseased side than in the healthy side, while in control group the leg length was averagely （1.08±0.51） cm shorter. There was significant difference between two groups. Compared to the control group, the curative effect was better in the experimental group. Conclusion Treating femoral intertrochanteric comminuted fractures with the modified Richards nail shows a good result, which can effectively diminish the non-union or m

关 键 词：股骨骨折 骨折固定术 内 骨螺丝 

分 类 号：R687.3[医药卫生—骨科学]