第三代Gamma钉治疗骨质疏松性股骨转子间骨折  

The application of third generation of Gamma nails in treatment of osteoporotic intertrochanteric fracture

作　　者：侯林俊[1] 朱治国[1] 孔祥录[1] 盖伟[1] 于远洋[1] 杨勇[1] 

机构地区：[1]首都医科大学燕京医学院附属良乡医院骨Ⅰ科,北京102400

出　　处：《临床和实验医学杂志》2012年第15期1202-1203,1205,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨第三代Gamma钉内固定治疗骨质疏松性股骨转子间骨折的疗效。方法 2008年1月至2011年5月应用第三代Gamma钉治疗骨质疏松性股骨转子间骨折患者238例,全部为低能量损伤,骨折按AO分型:A1型74例,A2型129例,A3型35例。受伤至手术时间平均为4.8 d(12 h～13 d),骨折采用闭合复位206例,有限切开复位32例,第三代Gamma钉内固定。结果平均手术时间41.2 min(27～126 min),术中平均失血量180 ml(80～550 ml),主钉入钉点切口平均3.1 cm(2.5～4.0 cm),56例患者术中需扩髓后放入主钉,其余患者无需扩髓即可插入主钉。随访时间平均13.4个月(1～20个月),共有11例发生了术后并发症,其中2例于术后2月内死亡。生存患者术后功能均恢复到伤前水平,骨折愈合时间平均4.2个月(3.1～6.2个月)。结论第三代Gamma钉是治疗骨质疏松性股骨转子间骨折有效的方法,准确复位,尽早手术,同时积极治疗骨质疏松,可获得满意疗效。Objective To explore the clinical efficacy of third generation of Gamma nails （ Gamma 3 ） in treatment of osteopomtic intertro- chanteric fracture. Methods Two hundred and thirty eight patients with osteoporetic intertrochanteric fracture during January 2008 to April 2011 were treated with Gamma3 nails. All these patients were suffered with low energy injury. According to AO classification, 74 cases belonged to A1 type, 129 cases to A2 type, and 35 cases to A3 type. The average duration from injury to operation was 4.8 days （ 12 h to 13 d）. Close reduction had been performed in 206 cases and limited open reduction in 32 cases. All these cases were fixed with Gamma3 nails. Results The average op- erating time was 41.2 min （ 27 ~ 126 rain）, and the average intraoperative blood loss was 180 ml （ 80 ~ 550 ml）. The average incision length was 3.1 cm （2.5 ~ 4.0 cm）. 56 cases underwent non -reamed intramedullary nail fixation and 182 cases underwent reamed intramedullary nail fixa- tion. All these patients were followed up for 1 to 20 months （with average of 13.4 months）. Postoperative complications were happened in 11 ca- ses, including 2 cases died within 2 months after operation. Fracture healing achieved in all patients with an average of 4.2 months （ 3.1 - 6.2 months）. Conclusion The application of Gamma 3 nails is an effective method in treatment of osteopomtic intertrochanteric fractures. Complete reduction, early operation and anti - osteoporosis therapy are conducted to get satisfactory outcome.

关 键 词：股骨转子间骨折 骨质疏松 GAMMA钉 内固定 

分 类 号：R687.3[医药卫生—骨科学]