标准γ-Ⅲ型带锁髓内针和解剖型钢板治疗股骨粗隆间骨折临床随访疗效的比较  

Comparison of the Outcomes in Femoral Intertrochanteric Fracture Treated by Reconstruction Plate and γ-Ⅲ Standard Interlocking Intramedullary Nail

作　　者：唐敏[1] 姜世平[1] 何健飞[1] 王建云[1] 郑东宛[1] 

机构地区：[1]广东公安边防总队医院骨科,广东深圳518029

出　　处：《实用预防医学》2011年第8期1516-1518,共3页Practical Preventive Medicine

摘　　要：目的探讨标准γ-Ⅲ型带锁髓内针和解剖型钢板在股骨粗隆间骨折治疗中的临床疗效。方法选择股骨粗隆间骨折患者76例,其中伽马钉组36例,解剖型钢板组40例。比较两组的术中观察指标(手术时间、切口长度、术中出血量)和术后观察指标(住院时间、负重时间、骨折愈合时间及并发症情况);对两组进行随访1年,按Harris标准评定两组患者术后髋关节功能,比较两组术后1年髋关节功能恢复情况。结果两组切开长度、术中出血量比较,差异有统计学意义(P<0.05)。两组手术时间、住院时间、负重时间和骨折愈合时间比较,差异无统计学意义(P>0.05)。标准γ-Ⅲ型带锁髓内针组术后并发症发生率明显低于解剖型钢板组(P<0.05)。76例患者均获得随访1年,两组患者术后1年患髋关节功能,解剖型钢板组优良率为85.0%,标准γ-Ⅲ型带锁髓内针组优良率为94.4%,标准γ-Ⅲ型带锁髓内针组的优良率明显高于解剖型钢板组(P<0.05)。结论标准γ-Ⅲ型带锁髓内针和解剖型钢板治疗股骨粗隆间骨折均可以获得较满意的疗效,但标准γ-Ⅲ型带锁髓内针手术创伤较小,并发症少,术后髋关节功能恢复优于解剖型钢板治疗,是目前治疗股骨粗隆间骨折比较理想的内固定材料。Objective To compare the outcomes in femoral intertrochanteric fracture treated by reconstruction plate and γ-Ⅲ Standard Interlocking Intramedullary Nail.Methods 76 patients underwent intertrochanteric fractured in our institusion were involved in this study.36 cases of them received open fracture reduction with γ-Ⅲ Standard Interlocking Intramedullary Nail,else for reconstruction plate fixation.Parameters either during operation（surgical duration,incision length,bleeding volume） nor after surgery（hospital day,weight bearing progress,fracture healing time,complications） were recorded.After one year follow up,function outcomes of involved hips were evaluated with Harris standard score system.Results Decreased operation duoration and hospital days,weight bearing time were better but not significant in the group of intramedullary fixation（all P0.05）.Patients underwent intramedullary nail fixation presented significant improvement in incision length,bleeding volume and complications after operation（all P0.05）.Function outcome in intramedullary nail group was increased with a rate of better-excellent at 94.4% versus 85.0% in plate treated.Difference was significant at 0.05 level.Conclusions Function outcome after intertrochanteric hip fracture can be satisfied when treated with either intramedullar or extramedullar fixation.γ-Ⅲ Standard Interlocking Intramedullary Nail,a less invasive procedure,got less complications and better function outcomes compared with standard plate fixation.

关 键 词：股骨粗隆骨折 标准γ-Ⅲ型带锁髓内针 解剖型钢板 

分 类 号：R683.42[医药卫生—骨科学]