防旋型股骨近端髓内钉与Gamma钉治疗老年股骨转子间骨折的疗效观察  

The curative effect of the treatment with proximal femoral nail anti-rotation and Gamma nail to intertrochanteric fractures of the aged patients

作　　者：郭震[1] 姚勐炜[1] 杨安礼[1] 

机构地区：[1]上海市杨浦区中心医院骨科,上海200090

出　　处：《临床骨科杂志》2011年第3期293-295,共3页Journal of Clinical Orthopaedics

摘　　要：目的比较防旋型股骨近端髓内钉(PFNA)与Gamm a钉治疗老年股骨转子间骨折的疗效。方法 99例老年股骨转子间骨折患者,53例使用PFNA固定,46例使用Gamm a钉固定,对两组手术时间、术中出血量、骨折愈合时间、并发症和髋关节功能等进行临床随访分析。结果平均手术时间和出血量PFNA组均少于Gamm a组,差异有统计学意义(P<0.01);骨折愈合时间两组比较差异无统计学意义(P>0.05);并发症发生率PFNA组低于Gamm a组,差异有统计学意义(P<0.05)。PFNA组和Gamm a组优良率分别为90.57%和86.96%,差异无统计学意义(P>0.05)。结论 PFNA设计合理,微创操作,出血少,固定可靠,是治疗老年股骨转子间骨折的理想方法之一,尤其适用于骨质疏松性股骨转子间骨折。Objective To discuss the characters of proximal femoral nail anti-rotation（PFNA） and Gamma nail for treating intertrochanteric fractures of the aged patients.Methods Among 99 cases of aged intertrochanteric fractures,53 cases were treated with PFNA and 46 cases were treated with Gamma nail.Operative time,volume of blood loss,fracture healing time,complications,and postoperative function were observed and compared.Results Average operation time and blood loss in PFNA group were less than Gamma group,the difference was statistically significant（P0.01）;There was no significant difference in the fracture healing time（P0.05）;There was significant difference in the complications（P0.05）;the rate of complications was lower in PFNA.Excellent and good rate was 90.57% in PFNA,and 86.96% in Gamma nail,and there was no significant difference between them（P0.05）.Conclusions PFNA is reasonably designed,which has advantages of small trauma and bleeding with reliable fixation.For senile people,it is one of ideal treatment of intertrochanteric fractures,especially for people who has osteoporosis.

关 键 词：股骨转子间骨折 骨折固定术 内 防旋型股骨近端髋内钉 GAMMA钉 老年人 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]