Richards钉与130°角钢板对股骨粗隆间骨折疗效的比较

目的：比较这２种方法治疗股骨粗隆间骨折（ＩＴＦＦ）的手术操作、疗效。方法：１９９４年３月～１９９５年９月用角钢板治疗２８例，１９９５年１０月～１９９７年６月用Ｒｉｃｈａｒｄｓ钉治疗３５例。手术指征和进路相同。结果：随访１０～４９个月。平均手术时间：Ｒｉｃｈａｒｄｓ钉组１ｈ２０ｍｉｎ，角钢板组１ｈ４５ｍｉｎ，平均出血量：Ｒｉｃｈａｒｄｓ钉组４３９ｍｌ，角钢板组４２２ｍｌ，２组无差异（Ｐ＞００５）。平均完全负重时间：Ｒｉｃｈａｒｄｓ钉组７６周，角钢板组９８周。并发症：Ｒｉｃｈａｒｄｓ钉组跛行２例（５７１％）。角钢板组跛行５例（１７８５％），伴疼痛３例（１０７１％），钢板断裂２例（７１４％）。结论：Ｒｉｃｈａｒｄｓ钉手术操作简便，完全负重早，并发症少。应为股骨粗隆间骨折治疗的首选方法。

Comparison of Richards Nail and 130 Angled Plate for Treatment of Intertrochanteric Fractures of the Femur

Objective:To compare the results and operative manipulation of two different methods for the treatment of intertrochanteric fracture of femur (ITFF).Methods:From March 1994 to September 1995,28 cases of ITFF were treated with 130 angled plate fixation.From October 1995 to June 1997,35 cases of ITFF were treated with Richards nail fixation.The operative indication and approach of the two different methods were the same.Results:Sixtythree patients were followedup for 10 to 49 months.Average time of operations,blood lose,time of recovery in tow groups were as follows:1 hour and 20min,439ml,76 weeks in Richards nail and 1 hour and 45min,422ml,98 weeks in angledplate respectively.Complications included 2 limp in Richards nail (571%),and 5 limp(1785%),3 local pain(1071%),2 implant breakage(714%)in angledplate.Conclusion:Richards nail for treatment of ITFF is simple to operate,with early functional recovery and much less complication than 130 angled plate.Therefore,Richards nail is the first choice for ITFF.