动力髋螺钉、Gamma钉、外固定架3种固定物治疗老年股骨转子间骨折

背景：临床常用动力髋螺钉、Gamma钉、外固定架治疗老年股骨转子间骨折，但如何选择尚没有一个标准可供参考。 目的：比较动力髋螺钉、Gamma钉、外固定架3种内固定物治疗老年股骨转子间骨折的效果。 方法：对168例老年股骨转子间骨折分别采用动力髋螺钉内固定53例，Gamma钉内固定58例，外固定架57例，比较3组手术时间、出血量、骨折愈合时间和术后并发症，观察术后关节功能。 结果与结论：术后随访6~35个月。Gamma钉组平均手术时间99.11 min，长于动力髋螺钉组和外固定架组(P < 0.05)，外固定架组时间最短(P < 0.05)。动力髋螺钉组出血量最多，外固定支架组最少，3组比较差异有显著性意义(P < 0.05)。外固定架组的并发症发生率明显高于动力髋螺钉组和Gamma钉组。骨折愈合时间及髋关节功能优良率3组比较差异无显著性意义(P > 0.05)。提示动力髋螺钉、Gamma钉及外固定架是治疗老年股骨转子间骨折的有效方法，各有优缺点，只要适应证掌握得当，根据病情合理选择固定物均能取得满意疗效。

Elderly intertrochanteric fractures treatment using dynamic hip screw, Gamma nail and external fixation frisket

BACKGROUND: Dynamic hip screw (DHS), Gamma nail and external fixation frisket are widely applied to treat elderly intertrochanteric fractures, but there are no relevant criteria available in the clinical selection. OBJECTIVE: To compare the therapeutic effects of DHS, Gamma nail and external fixation frisket in treatment of elderly intertrochanteric fractures. METHODS: 168 elderly patients with intertrochanteric fractures were divided into three groups, respectively treated with DHS (n=53), Gamma nail (n=58), and external fixation (n=57). The operative time, blood loss, fracture healing time, and postoperative complications were compared, and joint function after operation was observed. RESULTS AND CONCLUSION: The patients were followed up for 6-35 months. The mean operative time was 99.11 minutes in Gamma nail group, significantly longer than DHS and external fixation groups (P < 0.05). The amount of blood loss in DHS group was most, followed by Gamma nail, and then external fixation group (P < 0.05). The incidence rate of complications in external fixation group was significantly greater than the other groups. There were no differences in fracture healing time or hip joint function recovery (P > 0.05). DHS, Gamma nail and external fixation are effective methods for the treatment of intertrochanteric fractures. Each method has its own advantages and disadvantages. It can achieve satisfactory results with a reasonable choice for the state of illness.