Gamma 3 U-Blade系统治疗老年骨质疏松性股骨转子间骨折的早期疗效  

Short-term effectiveness of Gamma 3 U-Blade system for osteoporotic intertrochanteric fractures in the elderly

作　　者：范文斌 石柳[1,2,3] 谢添[1,2,3] 张程 陈翔溆[1,2,3] 陈辉[1,2,3] 芮云峰 FAN Wenbin;SHI Liu;XIE Tian;ZHANG Cheng;CHEN Xiangxu;CHEN Hui;RUI Yunfeng(Department of Orthopaedics,Zhongda Hospital Southeast University,Nanjing Jiangsu,210009,P.R.China;Trauma Center,Zhongda Hospital Southeast University,Nanjing Jiangsu,210009,P.R.China;Orthopaedic Trauma Institute of Southeast University,Nanjing Jiangsu,210009,P.R.China)

机构地区：[1]东南大学附属中大医院骨科,南京210009 [2]东南大学附属中大医院创伤救治中心,南京210009 [3]东南大学创伤骨科研究所,南京210009

出　　处：《中国修复重建外科杂志》2025年第1期47-52,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的与Gamma 3髓内钉比较,探讨Gamma 3 U-Blade系统治疗老年骨质疏松性股骨转子间骨折的早期疗效。方法回顾性分析2020年2月—2023年2月收治且符合选择标准的124例老年骨质疏松性股骨转子间骨折患者临床资料,内固定术中采用普通Gamma 3髓内钉65例(对照组)、Gamma 3 U-Blade系统59例(UB组)。两组患者年龄、性别、身体质量指数、美国麻醉医师协会(ASA)分级、骨密度、受伤至手术时间以及骨折分型、侧别等基线资料比较,差异均无统计学意义(P>0.05),具有可比性。比较两组手术时间、术中出血量、住院时间、骨折愈合时间,术后即刻尖顶距、骨折复位质量、拉力螺钉位置,末次随访时拉力螺钉滑动距离、颈干角变化值,术后12个月髋关节Harris评分,以及内固定相关并发症发生情况。结果UB组手术时间、术中出血量及住院时间较对照组略增加,但差异无统计学意义(P>0.05)。两组患者均获随访,随访时间12~24个月,平均17.1个月。术后12个月,两组髋关节Harris评分差异均无统计学意义(P<0.05)。影像学复查示,两组尖顶距、骨折复位质量、拉力螺钉位置组间差异均无统计学意义(P>0.05);骨折均顺利愈合,且愈合时间差异亦无统计学意义(P>0.05)。末次随访时,UB组颈干角变化值、拉力螺钉滑动距离均小于对照组,差异有统计学意义(P<0.05)。随访期间,UB组无内固定相关并发症发生,对照组6例(9.2%)发生并发症,发生率组间差异有统计学意义(P<0.05)。结论使用Gamma 3 U-Blade系统治疗老年骨质疏松性股骨转子间骨折可以获得良好早期疗效,影像学结果优于普通Gamma 3髓内钉。Objective To compare the short-term effectiveness between Gamma 3 intramedullary nails and Gamma 3 U-Blade system in the treatment of osteoporotic intertrochanteric fractures in the elderly.Methods A retrospective analysis was conducted on the clinical data of 124 elderly patients with osteoporotic intertrochanteric fractures,who were admitted between February 2020 and February 2023 and met the selection criteria.The fractures were fixed with Gamma 3 intramedullary nails in 65 patients(control group)and Gamma 3 U-Blade systems in 59 patients(UB group).The differences between the two groups were not significant in age,gender,body mass index,American Society of Anesthesiologists(ASA)classification,bone mineral density,time from injury to operation,fracture classification,and affected side(P>0.05).The operation time,intraoperative blood loss,hospital stay,and fracture healing time were recorded;the tip-apex distance,fracture reduction quality,and lag screw position were evaluated on X-ray films at immediate after operation;the lag screw sliding distance and change value of neck-shaft angle were measured on X-ray films at last follow-up.Harris hip score at 1 year after operation and the occurrence of internal fixation-related complications were compared between the two groups.Results The operation time,intraoperative blood loss,and hospital stay in the UB group increased compared to the control group,but the differences were not significant(P>0.05).All patients in both groups were followed up 12-24 months(mean,17.1 months).At 12 months after operation,there was no significant difference in the Harris hip score between the two groups(P<0.05).Radiological examination showed that there was no significant difference between the two groups(P>0.05)in terms of tip-apex distance,fracture reduction quality,and lag screw position.Fractures healed in both groups,and there was no significant difference in healing time(P>0.05).At last follow-up,the change value of neck-shaft angle and lag screw sliding distance in the UB group we

关 键 词：股骨转子间骨折 Gamma 3 U-Blade系统 髓内钉 内固定 骨质疏松 老年人 

分 类 号：R68[医药卫生—骨科学]