不同手术方式治疗129例股骨粗隆间骨折的疗效分析

目的:探讨不同手术方式治疗股骨粗隆间骨折的临床疗效。方法:回顾性分析我院收治的129例股骨粗隆间骨折患者的临床资料,其中行Gamma钉内固定手术47例,股骨近端髓内钉固定(PFN)45例、动力髋螺钉(DHS)37例,比较不同手术方式术中情况、临床疗效以及术后并发症。结果:对于EVANSⅠ～Ⅲ型患者,行Gamma钉内固定术中出血量少、术后并发症少,疗效优于PFN组,两组患者比较差异有统计学意义(P<0.05);EVANSⅣ～Ⅴ患者需要行髓内钉固定,减少股骨头内切割、畸形愈合等并发症,转子间骨折和高龄患者、骨质疏松患者可以选用DHS手术时间短,可以在较短时间内恢复髋关节的功能。结论:对于不同的骨折类型选用不同的内固定方式,Gamma钉内固定是治疗各类型骨折较为理想的方法,对于骨质疏松、不稳定骨折的患者可以采用DHS,提高手术安全性和有效性。

Different Surgical Treatment of 129 Cases of Intertrochanteric Fracture Analysis

Objective:To explore the different surgical treatment of intertrochanteric fractures of the clinical efficacy.Methods:A retrospective analysis of our hospital treated 129 cases of intertrochanteric fractures in patients with clinical data,including the line Gamma nail surgery,47 cases of proximal femoral nail(PFN) 45 cases,dynamic hip screw(DHS) 37 patients,comparing different surgical surgery,clinical efficacy and postoperative complications.Results:For patients with type EVANS Ⅰ ～ Ⅲ,the line Gamma nail less blood loss,fewer complications,more effective than the PFN group,two groups of patients the difference was statistically significant(P<0.05);EVANS Ⅳ ～ Ⅴ patients need line intramedullary nailing,cutting to reduce the femoral head,abnormal healing and other complications,elderly patients with intertrochanteric fractures and osteoporosis patients can use DHS shorter operative time,you can recover in a relatively short period of time the function of hip.Conclusion:For the selection of different types of fractures of different fixation methods,Gamma nail fixation is the treatment of various types of fractures ideal method for osteoporosis,can be used in patients with unstable fractures of the DHS,to improve surgical safety and efficacy.