锁定钢板联合股骨近端髓内钉治疗外侧壁破裂的股骨粗隆间骨折疗效分析  

作　　者：郭金库 王巍[1] 何飞熊[1] 谢俊[1] 吴盼 金乾坤[1] 

机构地区：[1]浙江省衢州市人民医院,324000

出　　处：《浙江临床医学》2020年第3期375-376,380,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省衢州市科技局项目(2019066)。

摘　　要：目的分析辅助锁定钢板联合股骨近端髓内钉治疗外侧壁破裂的股骨粗隆间骨折的疗效.方法回顾性分析2017年1月至2018年6月l5例外侧壁破裂股骨粗隆间骨折患者的临床资料,均采用牵引床复位股骨近端髓内钉联合锁定钢板内固定手术治疗.结果15例患者术后平均随访18.3个月(12~21个月),术前髋关节Harris评分35.2分(32~68分),术后6个月Harris评分81.9分(72~91分),与术前比较差异有统计学意义(t=15.64,P<0.05),其中优5例,良7例,可2例,差1例,优良率为80.00%.术后1年Harris评分平均85.5分(75~98分),与术前比较差异有统计学意义(t=8.88,P<0.05).其中优4例,良8例,可3例,差0例,优良率为80.0%.结论对外侧壁破裂的股骨粗隆间骨折,采用锁定钢板联合股骨近端髓内钉治疗,临床效果满意,不会延迟骨折愈合时间,围手术期并发症低,是治疗该类损伤较好的选择.Objective To respectively analyze the treatment effect of auxiliary lock plate associated proximal femur nail(GAMMAR Ⅲ)for the patients with peritrochanter fractures combining with later wall injured.Methods From January 2017 to December 2018,15 cases with femur peritrochanteric fracture combining lateral wall injured were retrospectively reviewed.All the patients were reducted with osthpedic tabel and fixed wth proximal femur nail(GAMMAR Ⅲ)combined with lock plate.Results The average follow-up time was 11 months(24?56 months);preoperation the average Haris score was 35.2.5(32~68),Six months after the operation,the average Haris score was 81.9(72~91)(t=15.64,P<0.05),including 5 cases of excellent,7 cases of good,2 cases of fair and 1 case of poor.The rate of excellent and good was 80.00%.The average Harris score of 1 year after the operation was 85.5(75~98)(t=8.88,P<05),including 4 cases of excellent,8 cases of good,3 cases of fair and 0 case poor.The rate of excellent and good was 80.0%.Conclusions For the peritrochanteric fracture with lateral wall injured,the clinical effect of auxiliary lock plate associated proximal femur nail is satisfactory,and the perioperative complications incidence is low,which can be a good choice for the treatment of this kind of fracture.

关 键 词：股骨粗隆部骨折 外侧壁 股骨近端髓内钉 辅助锁定钢板 

分 类 号：R68[医药卫生—骨科学]