髓内固定治疗老年性股骨转子间骨折的疗效分析  

Effect of intramedullary fixation on senile femoral intertrochanteric fractures

作　　者：苏中雷 王文娟 刘金峰 郭云涛 郭新安 段元涛 SU Zhonglei;WANG Wenjuan;LIU Jinfeng;GUO Yuntao;GUO Xin'an;DUAN Yuantao(Department of Traumatic Joint Surgery,The Eighth People's Hospital of Jinan,Jinan,Shandong 271104,China;Department of Cardiology,The Eighth People's Hospital of Jinan,Jinan,Shandong 271104,China)

机构地区：[1]济南市第八人民医院创伤关节外科,山东省济南市271104 [2]济南市第八人民医院心内科,山东省济南市271104

出　　处：《中南医学科学杂志》2022年第3期425-428,共4页Medical Science Journal of Central South China

摘　　要：目的 比较Gamma钉、亚洲型股骨近端防旋髓内钉(PFNA-Ⅱ)、联合压力交锁髓内钉(InterTan)对老年性股骨转子间骨折的治疗效果。方法 分析152例老年性股骨转子间骨折患者的临床资料,按髓内固定方式分为Gamma钉组、PFNA-Ⅱ组、InterTan组,并比较相关参数。结果 与Gamma钉组比较,PFNA-Ⅱ组和InterTan组手术时间、术中透视次数和出血量及围术期输血量减少(P<0.05);InterTan组骨折愈合时间、住院时间短于Gamma钉组和PFNA-Ⅱ组(P<0.05);术后1个月和12个月InterTan组髋关节功能Harris评分高于Gamma钉组和PFNA-Ⅱ组(P<0.05);以上指标其他组间比较,以及术后24个月3组Harris评分、并发症发生率差异无显著性(P>0.05)。结论 老年性股骨转子间骨折治疗需根据患者实际情况而定,PFNA-Ⅱ和InterTan手术操作方便、手术时间短,可减少术中透视次数及术中出血量;而InterTan愈合时间较短,髋关节功能恢复良好。Aim To compare the clinical effects of Gamma nail, Asian proximal femoral nail antirotation-Ⅱ(PFNA-Ⅱ) and interlocking intramedullary nail(InterTan) in the treatment of senile femoral intertrochanteric fractures.Methods The clinical data of 152 patients with senile femoral intertrochanteric fractures was analyzed. The patientswere divided into Gamma nail group, PFNA-Ⅱ group and Inter Tan group according to the intramedullary fixation method.Relevant parameters were compared. Results Compared with Gamma nail group,surgical time, frequency of intraop-erative fluoroscopy, intraoperative blood loss and perioperative blood transfusion volume of PFNA-Ⅱ group and Inter Tangroup were significantly shorter/less(P<0. 05), the fracture healing time and hospital stay of Inter Tan group were shorterthan those of Gamma nail group and PFNA-Ⅱ group(P<0. 05), the hip function Harris scores of Inter Tan group were sig-nificantly higher than those of Gamma nail group and PFNA-Ⅱ group at 1 month and 12 months after operation(P<0. 05),there were no significant difference among other groups in the above indicators, and among the three groups in hip functionHarris scores at 24 months after surgery or the incidence of complications(P>0. 05). Conclusions The treatment ofsenile femoral intertrochanteric fractures should be based on the patient’s actual condition. PFNA-Ⅱand Inter Tan are con-venient to operate and the surgical time is short. They can reduce the frequency of intraoperative fluoroscopy and intraopera-tive blood loss. However, fracture healing time of patients treated with InterTan is shorter, and hip function recovers well.

关 键 词：GAMMA钉 股骨近端防旋髓内钉 联合压力交锁髓内钉 老年性股骨转子间骨折 

分 类 号：R683.42[医药卫生—骨科学]