股骨近端仿生髓内钉与第三代Gamma钉固定治疗老年股骨转子间骨折的近期疗效比较  

Comparison of proximal femoral bionic nails and 3G Gamma nails in fixation of intertrochanteric femoral fractures in the elderly

作　　者：扈延龄[1] 张成栋[1] 宫海峰[1] 刘国明 梁承志 张英泽 Hu Yanling;Zhang Chengdong;Gong Haifeng;Liu Guoming;Liang Chengzhi;Zhang Yingze(Department of Trauma Surgery,The Hospital Affiliated to Qingdao University,Qingdao 266000,China;Trauma Emergency Center,The Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]青岛大学附属医院创伤外科,青岛266000 [2]河北医科大学第三医院创伤急救中心,石家庄050051

出　　处：《中华创伤骨科杂志》2024年第6期467-472,共6页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金面上项目(82272578)。

摘　　要：目的:比较股骨近端仿生髓内钉(PFBN)与第3代Gamma钉固定治疗老年股骨转子间骨折的近期疗效。方法:回顾性分析2021年10月至2022年12月期间青岛大学附属医院创伤外科收治的78例老年股骨转子间骨折患者资料。男35例,女43例;年龄(76.0±7.9)岁。骨折改良Evans分型:Ⅰ型6例,Ⅱ型21例,Ⅲ型24例,Ⅳ型23例,Ⅴ型4例。根据内固定方式不同分为两组:PFBN组35例,采用PFBN固定;Gamma钉组43例,采用第3代Gamma钉固定。比较两组患者的手术时间、术中出血量、住院时间、术后下地负重时间、骨折愈合时间、术后6个月髋关节Harris评分及疼痛视觉模拟评分(VAS)等。结果:两组患者术前一般资料比较差异均无统计学意义( P>0.05),具有可比性。所有患者术后获(14.0±4.0)个月随访。PFBN组和Gamma钉组患者的手术时间分别为(58.9±8.2)、(58.1±6.8)min,术中出血量分别为(138.0±24.9)、(126.8±25.7)mL,住院时间分别为(10.9±2.9)、(10.3±4.0)d,骨折愈合时间分别为(5.0±1.3)、(5.1±1.3)个月,术后6个月髋关节Harris评分优良率分别为82.9%(29/35)、76.7%(33/43),疼痛VAS评分分别为0(0,1)、1(0,1)分,并发症发生率分别为2.9%(1/35)、4.7%(2/43),以上项目两组患者之间比较差异均无统计学意义( P>0.05)。但PFBN组患者的术后下地负重时间为(5.3±1.2)周,显著早于Gamma钉组患者[(6.9±1.4)周],差异有统计学意义( P<0.05)。 结论:PFBN与第3代Gamma钉固定治疗老年股骨转子间骨折均可获得较为满意的近期疗效,但前者较后者固定术后患者下地负重时间更早,更有利于患者髋关节功能的恢复。ObjectiveTo compare the short-term efficacy between proximal femoral bionic nails(PFBN)and 3G Gamma nails in the fixation intertrochanteric femoral fractures in the elderly.MethodsA retrospective study was conducted to analyze the data of 78 elderly patients with intertrochanteric femoral fracture who had been admitted to Department of Trauma Surgery,The Hospital Affiliated to Qingdao University from October 2021 to December 2022.There were 35 males and 43 females with an age of(76.0±7.9)years.By Evans classification:6 cases of typeⅠ,21 cases of typeⅡ,24 cases of typeⅢ,23 cases of typeⅣ,and 4 cases of typeⅤ.The patients were divided into 2 groups according to their internal fixation methods:a PFBN group of 35 patients fixed by PFBN and a Gamma group of 43 cases fixed with 3D Gamma nails.The time from injury to operation,hospital stay,operation time,intraoperative blood loss,weight-bearing time,fracture healing time,and Harris hip score,visual analogue scale(VAS)and incidence of complications at 6 months after operation were compared between the 2 groups.ResultsThere was no significant difference in the preoperative general data between the 2 groups,showing comparability(P>0.05).All patients were followed up for(14.0±4.0)months.There were no significant differences between the PFBN and Gamma groups in operation time[(58.9±8.2)min versus(58.1±6.8)min],intraoperative blood loss[(138.0±24.9)mL versus(126.8±25.7)mL],hospital stay[(10.9±2.9)d versus(10.3±4.0)d],fracture healing time[(5.0±1.3)months versus(5.1±1.3)months],or good and excellent rate by the Harris hip score[82.9%(29/35)versus 76.7%(33/43)],VAS score[0(0,1)points versus 1(0,1)points],or incidence of complications at 6 months after operation[2.9%(1/35)versus 4.7%(2/43)](all P>0.05).However,the complete weight-bearing time for the PFBN group was(5.3±1.2)weeks,significantly earlier than that for the Gamma group[(6.9±1.4)weeks](P<0.05).ConclusionIn the fixation of intertrochanteric femoral fractures in the elderly patients,both PFBN and 3

关 键 词：髋骨折 骨折固定术 髓内 骨钉 老年人 股骨近端仿生髓内钉 

分 类 号：R687.3[医药卫生—骨科学]