两种内固定方法治疗股骨粗隆间骨折疗效比较  

Comparison for two internal fixation methods of intertrochanteric fracture treatment

作　　者：彭建全[1] 张剑慧[1] 戴致波[1] 谭花云[1] 严名扬[1] 

机构地区：[1]湖南中医药高等专科学校第一附属医院骨二科,湖南株洲412000

出　　处：《中国现代医学杂志》2010年第8期1233-1236,共4页China Journal of Modern Medicine

摘　　要：目的探讨不同方法治疗股骨粗隆间骨折的手术适应证及疗效。方法 2007年1月～2009年6月,收治86例股骨粗隆间骨折患者。其中,36例采用动力髋螺钉(DHS)固定,50例采用伽玛钉(GN)固定。所有病人按中医骨科三期辨证原则,早期服用本院中成药:伤科合剂1号,外敷伤科粉;中期服用接骨合剂;后期服用壮骨合剂。伤口愈合后,外用下肢熏洗方熏蒸。结果患者均获随访9个月～2年,平均15.2个月。DHS组远端内移1例,股骨头坏死2例;GN组拉力螺钉切出1例,股骨头坏死1例;予对症处理骨折愈合。余患者于术后10～15周骨折达临床愈合。髋关节功能根据Brumback评价标准评定,6个月后,DHS手术治疗者优24例,良10例,差2例;GN手术治疗者优35例,良13例;差2例。结论股骨粗隆间骨折手术方案应综合考虑骨折类型、内固定器材特点以及患者病情,采取个性化的治疗方案;配合术前、术后中医辨证用药及内外用药,能够提高疗效、减轻症状及缩短疗程。【Objective】To explore surgical indications and efficacy of intertrochanteric fractures under different methods of treatment.【Methods】Treatment was done with 86 intertrochanteric fracture sufferer during Jan,2007 and June,2009.which was including 53 Male and 33 female whose age were around 21-101 and whose average age were around 47.6.30 cases was traffic injury,9 cases of fall height injury and 47 cases of slip down injury.To classify each by AO as follows： 51 cases of A1-type,22 cases of A2-type,13cases of A3-type.and there is 36 cases in which ultilized by the fixation method of dynamic hip screw（dynamic hip screw,DHS）,50 cases adopt fixation method of gamma nail（Gamma nail,GN）.All the patients was treated under the three syndromes principles of tradi-tional Chinese medicine orthopedic three syndromes,the early Court to take Chinese medicine： Medical Division mixture 1,for external wounds Section powder,medium-term taking bone mixture,post-taking Zhuanggu mixture,after the external lower extremity wound healing fumigation Fumigation side.【Results】The patients were followed up 9 months-2 years,an average of 15.2 months.DHS group distal shift in 1 case,whirlbone necrosis in 2 cases;GNgroup of lag screw cut out of 1 case,1 case of whirlbone necrosis;which is to the symptomatic treatment of fracturehealing.The other patient would be healthy after 10-15 weeks of clinical fracture healing.Hip joint function was as-sessed according to Brumback evaluation criteria 6 months later,DHS surgical treatment of 24 cases were excellent,10 cases of them were good and 2 cases of them were poor;GN surgical treatment of 35 cases were excellent,13cases of them were good;2 cases of them were poor.【Conclusion】Intertrochanteric fractures surgery programshould be comprehensive consideration the type of fracture,the characteristics of internal fixation devices and thepatient’s condtion,to take individualized treatment programs;with preoperative and postoperative of TCM diagnosis and prescription and interna

关 键 词：股骨粗隆间骨折 动力髋螺钉 伽玛钉 辨证施治 内外用药 

分 类 号：R683.42[医药卫生—骨科学]