股骨近端防旋髓内钉与Gamma钉治疗老年人转子间骨折的疗效比较分析  

Comparison of effect of standard Gamma nail and proximal femoral nail anti-rotation for geriatric intertrochanteric fractures

作　　者：纪泉[1] 薛庆云[1] 王强[1] 吴刚[2] 文良元[1] 赵立连[1] 路奎元[1] 申剑[1] 黄公怡[1] 

机构地区：[1]北京医院骨科,100730 [2]北京同仁医院骨科,100730

出　　处：《中国矫形外科杂志》2010年第10期796-799,共4页Orthopedic Journal of China

摘　　要：[目的]比较分析股骨近端防旋髓内钉与Gamma钉对老年人骨质疏松性股骨转子间骨折的临床疗效。[方法]随访病例共123例,其中2002年5月～2005年9月入院的股骨转子间骨折病例中有55例患者使用Gamma钉固定,2005年11月～2008年6月的转子间骨折患者有68例患者使用PFNA治疗,从术中、术后并发症、骨折愈合以及术后髋关节功能对两种治疗方法的临床疗效进行比较分析。[结果]股骨近端防旋髓内钉与Gamma钉的术中失血量、输血量、感染、深静脉血栓形成、住院日方面统计学无显著性差异,末次随访骨折愈合率两组无显著性差异,Gamma钉组有1例患者发生股骨头坏死,髋部疼痛发生率较PFNA组稍高,但髋关节功能Harris评分两组无明显差异。[结论]PFNA与SGN治疗老年人股骨转子间骨折对骨折周围软组织医源性创伤小,骨折可稳定固定,并发症较少,均为治疗老年人股骨转子间骨折的可靠方法。[Objective]To investigate and compare the effects of standard gamma nail （SGN） and proximal femoral nail anti-rotation （PFNA） in the treatment of osteoporotic intertrochanteric fractures in the elderly.[Method]From May 2002 to September 2005,55 patients with intertrochanteric fractures were treated with SGN.Sixty-eight patients were treated with PFNA from November 2005 to June 2008.The effects of the two implants about perioperative complications,bone healing and the function of the operated hip joint were compared.[Result]No statistically significant difference was found between the two groups in blood loss,blood transfusion,infection,deep venous thrombosis and hospital stay.One patient developed femoral head avascular necrosis postoperatively in Gamma nail group.The incidence of postoperative hip pain in Gamma nail group was higher than that in the PFNA group,but there was no significant difference in the Harris score.[Conclusion]Gamma nail and PFNA nail are reliable methods to treat geriatric intertrochanteric fractures,with advantages of minimal iatrogenic injury,stable fixation and few complications.

关 键 词：转子间骨折 股骨近端防旋髓内钉 内固定 GAMMA钉 疗效 

分 类 号：R687.3[医药卫生—骨科学]