股骨近端防旋髓内钉与Gamma3钉内固定治疗老年股骨转子间骨折的疗效比较  

Comparison efficacy of proximal femoral nail anti-rotation and Gamma3 nail internal fixation in the treatment of elderly patients with femoral intertrochanteric fracture

作　　者：隋聪[1] 刘德宝[1] SUI Cong;LIU De-bao(Dept of Orthopaedics,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui230022,China)

机构地区：[1]安徽医科大学第一附属医院骨科创伤骨科

出　　处：《临床骨科杂志》2019年第4期474-476,481,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较股骨近端防旋髓内钉(PFNA)与Gamma3钉内固定治疗老年股骨转子间骨折的临床疗效。方法将40例老年股骨转子间骨折患者按照手术方式不同分为Gamma3组和PFNA组,每组20例。记录手术时间、术中出血量、尖顶距等手术指标,采用Harris评分评价髋关节功能恢复情况。结果患者均获得随访,时间6~12个月。手术时间、术中出血量、尖顶距PFNA组少(小)于Gamma3组,但差异无统计学意义(P>0.05);术后骨折愈合时间PFNA组短于Gamma3组,但差异无统计学意义(P>0.05);术后3个月髋关节功能恢复情况两组比较差异无统计学意义(P>0.05);术后并发症发生率两组比较差异无统计学意义(P>0.05)。结论PFNA与Gamma3钉治疗老年股骨转子间骨折均能获得良好疗效,两种手术操作简单、固定牢靠,临床可根据患者具体情况选择手术方式。Objective To compare the clinical efficacy of proximal femoral nail anti-rotation(PFNA)and Gamma3 nail in the treatment of elderly intertrochanteric fracture.Methods Forty elderly patients with femoral intertrochanteric fracture who received treatment were divided into the PFNA group and Gamma3 group according to the surgical method.Each group had 20 cases.The operative time,intraoperative blood loss and tip-apex distance(TAD)of the patients were recorded and compared,and the hip joint function recovery were evaluated by Harris scoring.Results All patients were followed up from 6 months to 12 months.The operative time,intraoperative blood loss and TAD of patients in the PFNA group were less than those in the Gamma3 group,but the differences were no statistically significant(P>0.05).The postoperative fracture healing time in the PFNA group was shorter than that in the Gamma3 group,and the difference was not statistically significant(P>0.05).There were no statistically significant differences in the hip joint functional recovery of postoperative 3 months(P>0.05).There was no statistically significant difference in the incidence rate of postoperative complications between two groups(P>0.05).Conclusions PFNA and Gamma3 nail have achieved good results in the treatment of elderly femoral intertrochanteric fractures.The two kinds of surgery are simple and reliable,and the surgical method can be selected clinically according to the specific situation.

关 键 词：股骨近端防旋髓内钉固定 Gamma3钉固定 老年人 股骨转子间骨折 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]