Gamma钉和动力髋螺钉内固定治疗股骨转子间骨折临床疗效比较

目的比较Gamma钉和动力髋螺钉治疗股骨转子间骨折的疗效。方法将100例股骨转子间骨折患者随机分为2组(各50例),分别进行Gamma钉以及DHS治疗,对两组患者住院时间、下床时间以及骨折愈合时间、并发症进行比较。结果住院时间、下床时间、骨折愈合时间:Gamma钉组分别为(12.4±2.3)d、(63.8±4.9)d、(9.8±1.3)d;DHS组分别为(15.6±1.4)d、(84.7±3.9)d、(13.2±2.9)d;两组三方面比较差异均有统计学意义(P<0.05)。按Sahin et al法评定疗效:Gamma钉组优35例,良12例,差3例,优良率94%;DHS组优13例,良27例,差10例,优良率80%;两组比较差异有统计学意义(P<0.05)。并发症比较:Gamma钉组切口感染2例,股骨骨折4例,髋内翻2例,发生率16%;DHS组切口感染3例,股骨骨折3例,髋内翻8例,发生率28%;Gamma钉组髋内翻发生率低于DHS组(P<0.05)。结论 Gamma钉治疗股骨转子间骨折的疗效明显优越于DHS治疗。

Comparison of Gamma nail and dynamic hip screw for femoral intertrochanteric fractures

Objective To compare the clinical effect of the Gamma nail and dynamic hip screw(DHS) for intertrochanteric fractures.Methods 100 patients with femoral intertrochanteric fracture were randomly divided into two groups,with every group 50 patients,which were treated by Gamma nail and DHS.Results The two groups of patients was compared by length of stay,bed time,and fracture healing time.In Gamma nail group,the hospital stay,bed time,fracture healing time were respectively(12.4 ± 2.3) d,(63.8 ± 4.9) d,(9.8 ± 1.3) d;while in DHS group,those were(15.6±1.4)d,(84.7±3.9)d,(13.2±2.9)d,and there were significant differences(P<0.05).With Sahin et al evaluation method,Gamma nail group were excellent in 35 cases,good in 12 and poor in 3,the rate of excellent and good was 94%,while DHS group were excellent in 12 cases,good in 27 and poor in 10,the rate of excellent and good was 80%,and there were a significant treatment difference(P<0.05);Comparison of two groups of patients with complications,Gamma nail group got wound infection in 2 cases of femoral fractures 4 cases,and hip varus in 2 cases(16%).DHS group got incision infection in 3 cases,fracture of femur in 3,and coxa vara in 8(28%).Gamma nail group had lower incidence of hip varus than DHS group(P<0.05).Conclusions Gamma nail for intertrochanteric fractures in the treatment group is significantly superior to the DHS.