InterTan髓内钉与Gamma3钉治疗老年股骨转子间骨折的疗效比较  

Comparison ofInterTan and Gamma-3 nails in treatment of intertrochanteric fracture in the elderly

作　　者：王建伟[1] 姜朝来[2] 张长青[1] 曾炳芳[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,200233 [2]上海交通大学附属第六人民医院东院骨科

出　　处：《中华创伤骨科杂志》2013年第2期107-112,共6页Chinese Journal of Orthopaedic Trauma

摘　　要：目的比较InterTan髓内钉与Gamma 3钉治疗老年股骨转子间骨折的｜临床疗效。 方法回!顺坝忆怕性I：.分析2却01川0年5月至l山2月收治的50 t伊例目列j老年股骨转子间骨折思者资料，根据内固定方式不同分为两平均年龄为（仆78.4 ± 6. I）岁，骨折AO分型：AI型8例，A2型15例，A3型2例。Gamma 3钉组（采用Gamma 3钉内问定治疗） 25例，男7例，女18例;平均年龄为（79.2±7.8）岁;骨折AO分型：AI型10例，A2型13例，A3型2例。记录并比较两组患者的手术时间、术中出血挝、骨折愈合时 间、榄关节Harris评分及并发症的发生情况。结果 InterTan髓内钉组和Gamma 3钉组术后各有23例忠者获得随访，平均随访时间分别为13.4、13.6个月。InterTan髓内钉组和Gamma 3钉组患者手 术时间平均分别为（71. 5 ± 19. 3）、（6L3±13.9） min，差异有统计学意义（1=0.120， P=0.044）;术rl＇Illu航：L!平均分别为（183.9 ±69. 3）、（182. I ±68. 8） mL，骨折愈合时间平均分别为（3. I ±0. 8）、（3. I土 0.6）个月，俄关节Harris评分平均分别为（83. 7士5.7）、（82.2 ±6. 4）分，并发症发生率平均分别为 8.7%（2/23）、13.0% （3123），以上项目两组间比较差异均无统计学意义（P〉 0.05）。结论两种 内阁定均可靠、效果良好， Interl、an髓内钉更适合骨质疏松严重或粉碎性骨折患者，Gamma 3钉因手术时间短可用于对手术耐受较差的患者。To compare clinicaJ outcomes of Tan and Gamma-3 nails in treatment of intertrochanteric fractures in the elderly. Methods We retrospectively compared the 50 old patients with intertrochanteric fracture who had been treated in Ollr department from May to December 2010. Half of them were treated with InterTan nails and half with Gamma-3 nails. In the InterTan group, there were 9 men and 16 women, with an average age of 78.4 ± 6. I years; there were 8 A I fractures, 15 A2 ones and 2 A3 ones according to the AO classification. In the Gamma group, there were 7 men and 18 women, with an average age of 79. 2士7.8 years; there were 10 AI fractures, 13 A2 ones and 2 A3 ones according to the AO classifi-cation. The 2 groups were compared in terlTIS of operative time, intraoperative blood loss, fracture healing time, Harris hip score and complications. Results Twenty-three patients in each group were followed lip for an average of 13.4 months and 13.6 months respectively. The operative time was 71. 5 ± 19.3 minutes and 61. 3 ± 13. 9 minutes respectively for the InterTan and Gamma groups, with a significant difference （p 〈 0.05）. However, there were no significant differences between the 2 groups regarding blood loss （183.9 ± 69. 3 mL us. 182. I ±68. 8 mL）, fracture healing time （3. I ±O. 8 months vs. 3. I ±O. 6 months）, Harris hip score （83. 7 ± 5. 7 points82.2 ±6. 4 poin时, or complication rate [8.7% （2/23）ω.13.0% （3123）] （P〉 O. 05）. Conclusions Roth InterTan and Gamma-3 n剧Is can be used to treat femoral intertrochanteric fractures in the elderly patients, resulting in good clinical outcomes. InterTan nails may have a biomechanical advantage for pat ients with seriolls osteoporosis or comminuted fractures while Gamma-3 nails may be a better choice for patients with poor operative tolerance.

关 键 词：髋骨折 骨钉 骨折固定术 髓内 回顾性研究 

分 类 号：R687.3[医药卫生—骨科学]