微创术式Gamma3型髓内钉内固定治疗137例老年股骨转子间骨折  

Evaluation of Minimally Invasive Surgery with Type 3 Gamma Nail in the Treatment of Intertrochanteric Fracture in 137 Elderly Patients

作　　者：狄鸥[1] 刘莅彤[1] 宋国庆[1] 

机构地区：[1]解放军254医院骨科,天津300142

出　　处：《解放军医药杂志》2011年第1期40-42,110,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨微创术式Gamma3型髓内钉内固定治疗老年股骨转子间骨折的方法和原理。方法对我院2006年6月～2010年6月采用微创术式Gamma3型髓内钉内固定治疗的137例老年股骨转子间骨折的临床资料进行回顾性分析。结果本组术后均达到或接近解剖复位。手术切口平均长7.0 cm,手术时间平均40 min,术中出血平均100 ml。所有切口均一期愈合。随访6～48周,平均17周,骨折均临床愈合,平均愈合时间8周。137例中股骨颈短缩26例,均无拉力螺钉切出股骨头、髋内翻畸形及股骨干骨折。术后8周115例伤肢功能恢复到伤前状态,22例需手杖辅助步行。术后患侧股骨大转子顶部轻度疼痛15例,但不影响行走活动。结论微创术式Gamma3型髓内钉内固定治疗老年股骨转子间骨折具有手术创伤小、术中及术后并发症少、术后离床活动时间早的特点,值得临床推广应用。Objective To investigate the methods and mechanism of Type 3 Gamma nail in minimally invasive surgery in the treatment of intertrochanteric fracture in elderly patients.Methods From June 2006 to June 2010,137 elderly patients with intertrochanteric fracture received minimally invasive surgery with the internal fixation of type 3 Gamma Nail in our hospital.The clinical data was respectively analyzed.Results In all cases,the fractures were close to the anatomical reduction after operation.The average length of the incision was 7.0 cm,the average time of the operation was 40 min,and the average capacity of the blood loss during operation was 100 ml.All the incisions primarily healed.The follow-up was performed from 6 weeks to 48 weeks,and the average follow-up period was 17 weeks.All fractures clinically healed,and the average time of the clinical fracture healing was 8 weeks.No complications of hip varus,screw cut out and the fracture of femoral shaft occurred in any of the 137 patients,while shortening of the femoral neck occurred to 26 patients.8 weeks after operation,the functions of the injured lower limbs in 115 cases recovered to normal condition and 22 cases needed the assistance of walking stick.15 cases had slight pain in the intertrochanteric tip of the injure lower limbs with no influence in walking ability.Conclusion The method of internal fixation of type 3 Gamma Nail in treating the intertrochanteric fracture in elderly patients may possess the characteristics of minimal invasion,less complications during and after operation and early activity from bed after operation.

关 键 词：股骨骨折 髋骨折 骨折固定术 髓内 外科手术 微创性 老年人 

分 类 号：R683.42[医药卫生—骨科学]