DHS与Gamma钉治疗股骨粗隆间骨折的疗效比较.docVIP

DHS与Gamma钉治疗股骨粗隆间骨折的疗效比较 　　作者：张发平，王子明，王爱民 作者单位：富顺县人民医院骨科，四川 富顺643200;第三军医大学大坪医院野战外科研究所骨科，重庆400042 　　【摘要】 目的探讨动力髋螺钉钢板(DHS)和Gamma钉治疗股骨粗隆间骨折的疗效和术中注意事项。方法对54例股骨粗隆间骨折分别采用DHS内固定40例，Gamma钉内固定14例，比较两组平均手术时间、出血量、骨折愈合时间和术后并发症，观察术后关节功能。结果两组的手术时间、出血量、骨折愈合时间、术后并发症和关节功能恢复情况无显著统计学差异。髋关节功能优良率二组分别为95%、92.8%。术后随访时间DHS组平均20个月，Gamma钉平均13个月，所有病例均骨性愈合，愈合时间DHS组平均15周，Gamma钉组平均14周。结论DHS和Gamma钉是治疗股骨粗隆间骨折的有效内固定方法，各有优缺点，只要适应证掌握得当，手术操作规范，均能取得满意疗效。 　　【关键词】 股骨骨折;髋关节;内固定 　　Therapeutic effect of treatment of femoral trochanter fracture with DHS and Gamma nail 　　ZHANG Faping,WANG Ziming,WANG Aimin 　　Department of Orthopedics,Peoples Hospital of Fushun,Fushun643200,China 　　Abstract：ObjectiveTo discuss the therapeutic effect of DHS and Gamma nail in treatment of femoral trochanter fracture.MethodsFiftyfour femoral trochanter fracture patients were divided into two groups.Forty patients were treated with dynamic hip screw plates and fourteen patients were treated with Gamma nails,and the average operation time,blood loss,the time of bone heal,and the postoperative complications and the hip function of the two groups were compared.ResultsThere was no significant difference in the average operation time,blood loss,the time of bone healing and the postoperative complications and the joint function recovery of two groups.The excellent and good rate of the hip joint function were 95% and 92.8% respectively.The mean followup time of DHS group was twenty months,the Gamma nail group was thirteen months.All fractures were healed,the mean healing time was fifteen weeks and fourteen weeks in DHS group and Gamma group respectively.ConclusionDHS and Gamma nail were effective internal fixations to treat the femoral trochanter fracture,both of them have advantages and shortcomings,but satisfactory therapeutic effect can be attained if we grasp the indication and norm operative procedure. 　　Key words：femoral fracture;hip joint;internal fixation 　　股骨粗隆间骨折是老年人常见损伤，非手术治疗须长期卧床，易出现各种并发