MTDHS、DHS及Gamma钉内固定对股骨转子随骨折患者Harris评分的影响

目的探讨股骨转子间骨折患者应用各种不同内固定方法的治疗效果，并进行对比研究。方法回顾性分析82例股骨转子间骨折患者应用不同内固定方法治疗的临床资料，其中27例应用微创动力髋螺钉（MTDHS）内固定进行治疗，设立为A组。29例应用动力髋螺钉（DHS）内固定进行治疗，设立为B组。26例应用Gamma钉内固定治疗股骨转子间骨折，设立为C组，对比分析各组的手术观察指标及并发症以及对Harris评分的影响。结果A组手术用时最短，术中出血量最少，且术后患者住院时间最短，术后患者卧床时间最短、术后临床愈合快。A组并发症发生率明显低于B组（χ2=7．324，P〈0．05）、C组（χ2=5．673，P〈0．05）差异有统计学意义。术后随访1、2年，A组Harris评分优良率明显高于B组、C组，差异有统计学意义（P〈0．05）。结论MTDHS手术时间短、出血量少、术后并发症发生率低．Harris评分优良率高，对于治疗股骨转子间骨折具有很大的优势。

Effect and influence on harris hip score of intertrochanteric fractures by MTDHS,DHS and gamma nail fixation

Objective The patients with intertrochanteric fracture fixation methods for a variety of treatment were compared.Methods A retrospective analysis of 82 cases patients with intertrochanteric fracture fixation methods in different clinical data,of which 27 cases of minimally invasive dynamic hip screw(MTDHS) fixation for treatment,setting up for the A group.29 cases of application of dynamic hip screw(DHS) fixation for treatment,setting up for the B group.26 Application of Gamma nail fixation of intertrochanteric fractures,the establishment of group C,group comparative analysis of the observed indicators and complications of surgery,as well as the impact of the Harris score.Results A group operation with the shortest,least amount of blood loss and postoperative hospital stay was the shortest,the shortest postoperative bed,after clinical healing.A group of complications was significantly lower than group B(χ2=7.324,P < 0.05),C group(χ2=5.673,P < 0.05),the difference was statistically significant.2-year postoperative follow-up,A group of excellent Harris hip score was significantly higher than the B group,C group,the difference was statistically significant(P < 0.05).Conclusion DHS,Gamma nail more,MTDHS shorter operative time,less blood loss,postoperative complication rate is low,Harris score good rate,for the treatment of intertrochanteric fractures with a great advantage.