螺旋刀片与螺钉固定股骨头治疗老年粗隆间骨折的临床疗效研究  

Comparative study of the helical blade and screw in treating intertrochanteric fractures of elderly patients

作　　者：李山珠[1] 徐超[2] 袁锋[1] 李国华[2] 闵晓辉[1] 程黎明[1] 

机构地区：[1]上海同济大学附属同济医院骨科,200065 [2]新疆医科大学附属第二医院骨科,乌鲁木齐830063

出　　处：《中国矫形外科杂志》2014年第4期289-293,共5页Orthopedic Journal of China

基　　金：上海市卫生局局级科研项目(编号:20120403)

摘　　要：[目的]探讨螺旋刀片与螺钉固定股骨头在治疗老年低能量粗隆间骨折中的应用。[方法]对193例老年粗隆间骨折随机分组,实施动力髋螺钉、动力髋刀片、股骨近端髓内钉、Gamma髓内钉手术,股骨头内固定为螺钉者为一组(动力髋螺钉和Gamma髓内钉),股骨头内固定为螺旋刀片者为一组(动力髋刀片和股骨近端髓内钉)。术后进行至少2年随访。记录术后尖顶距和股骨头内固定位置及随访的并发症结果并进行统计学分析。[结果]刀片组101例患者中94例获得随访,螺钉组92例患者中83例获得随访。两组间的平均尖顶距、尖顶距>25 mm的百分比和内固定位置中心患者的百分比差异均无统计学意义;内固定切出率也无统计学差异。[结论]对于老年低能量粗隆间骨折,股骨头固定使用螺钉或螺旋刀片的作用相当,远期疗效有待于进一步随访。[ Objective] To study the application of the helical blade and screw fixation on treating the low energy intertro- chanteric fracture of elderly patients. [ Method] Totally 193 elderly patients with intertrochanterie fractures were randomly der- ided into 4 groups ： dynamic hip system screw, dynamic hip system blade, Gamma trochanteric nail and proximal femoral nail an- tirotation. The blade group received dynamic hip system blade and proximal femoral nail antirotation and the screw group re- ceived dynamic hip system screw and Gamma trochanteric nail. Patients were followed up for at least 2 years. Tip - apex distance and zone location of the cephalic implant were observed and complications were statistically analyzed. [ Result] Ninty-four of the blade group（ 101 ） and 83 of the screw group（92） were followed up. There was no significant difference concerning coverage tip - apex distance, percentage of patients with a tip - apex distance 〉 25 mm, and patients with a centre - centre position of the cephalic implant. And the reoperation or cut - out rate of blade group was not significantly different from screw group either. [ Conclusion] For the femoral head fixation of the elderly intertrochanterie fracture, a screw and a helical blade performed e- qually, however, further following - up is needed.

关 键 词：刀片 螺钉 粗隆间骨折 内固定 手术治疗 

分 类 号：R687.3[医药卫生—骨科学]