V形钉、髋加压螺钉治疗粗隆间骨折回顾性研究  

V shape intramedullary nail versus sliding hip screw for the treatment of intertrochanteric hip fracture-retrospective research

作　　者：何伟民[1] 

机构地区：[1]上海市静安区中心医院骨科,上海200040

出　　处：《河北医学》2002年第3期211-213,共3页Hebei Medicine

摘　　要：目的 :评价V形钉、髋加压螺钉治疗粗隆间骨折的疗效。方法 :用回顾性研究方法分析178例粗隆间骨折患者。比较分析二种内固定装置的手术时间、出血量、费用效果比、运动指数、并发症等。结果 :随访 136例 ,随访时间 6～ 14 7月 (平均 4 1月 )。二组对不稳定型骨折疗效无明显差异 ,但DHS平均用血量、住院费用远远超过V形钉组 (P <0 .0 0 1)。不稳定型骨折中 ,V形钉组并发症为 2 7.2 % ,DHS组为 19.4 %。结论 :稳定性粗隆骨折采用V形钉治疗具有创伤小、出血少、费用低的优点 ;Singh指数对评价骨折患者的骨骼强度有很好的实用价值 ;严重骨质疏松、不稳定型骨折、过早负重是内固定失败的主要原因。Objective: The purpose of this study was to assess clinical results for treatment of intertrochanteric with V shape intramedullary nail and DHS. Methods: A retrospective review of 178 intertrochanteric fracture was performed. The comparative analysis of surgical time ,estimated blood loss,cost-effects,mobility score and complications of two divices were made. Results: 136 cases were available for analysis. The period of follow up from 6～147 months(mean,41months). There was no statistically significant difference in curative effects for stable fracture in both groups(P>0.5).But ,there was a significantly higher in average blood transfusion and hospital charge among fractures treated with DHS(P<0.001). Complications rates of unstable trochanteric fractures treated with V shape nail and DHS were 27.2% and 19.4%, respectively.Conclusion: The V shape nail for treatment of the stable trochanteric(Even's grade 1 and 2) has proved to be a little of lesion for normal tissues, less blood loss and lower cost. In prediction of fixation failure and clinical results, Singh score were very veauable by evaluation of bone quality. The failure of fixation occurred most often at patients with severe osteoporosis, unstable frecture and very early weitght-bearing.

关 键 词：V形钉 DHS 费用效果比 并发症 粗隆间骨折 股骨骨折 

分 类 号：R683.42[医药卫生—骨科学]