中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2013年
2期
107-112
,共6页
王建伟%姜朝来%张长青%曾炳芳
王建偉%薑朝來%張長青%曾炳芳
왕건위%강조래%장장청%증병방
髋骨折%骨钉%骨折固定术,髓内%回顾性研究
髖骨摺%骨釘%骨摺固定術,髓內%迴顧性研究
관골절%골정%골절고정술,수내%회고성연구
Hip fractures%Bone nails%Fractures fixation,intramedullary%Retrospective studies
目的 比较InterTan髓内钉与Gamma3钉治疗老年股骨转子间骨折的临床疗效.方法 回顾性分析2010年5月至12月收治的50例老年股骨转子间骨折患者资料,根据内固定方式不同分为两组:InterTan髓内钉组(采用InterTan髓内钉内固定治疗)25例,男9例,女16例；平均年龄为(78.4±6.1)岁,骨折AO分型:A1型8例,A2型15例,A3型2例.Gamma 3钉组(采用Gamma 3钉内固定治疗)25例,男7例,女18例；平均年龄为(79.2±7.8)岁；骨折AO分型:A1型10例,A2型13例,A3型2例.记录并比较两组患者的手术时间、术中出血量、骨折愈合时间、髋关节Harris评分及并发症的发生情况. 结果 InterTan髓内钉组和Gamma 3钉组术后各有23例患者获得随访,平均随访时间分别为13.4、13.6个月.InterTan髓内钉组和Gamma 3钉组患者手术时间平均分别为(71.5±19.3)、(61.3±13.9) min,差异有统计学意义(t=0.120,P=0.044)；术中出血量平均分别为(183.9±69.3)、(182.1±68.8) mL,骨折愈合时间平均分别为(3.1±0.8)、(3.1±0.6)个月,髋关节Harris评分平均分别为(83.7±5.7)、(82.2±6.4)分,并发症发生率平均分别为8.7％ (2/23)、13.0％ (3/23),以上项目两组间比较差异均无统计学意义(P＞0.05). 结论 两种内固定均可靠、效果良好,InterTan髓内钉更适合骨质疏松严重或粉碎性骨折患者,Gamma 3钉因手术时间短可用于对手术耐受较差的患者.
目的 比較InterTan髓內釘與Gamma3釘治療老年股骨轉子間骨摺的臨床療效.方法 迴顧性分析2010年5月至12月收治的50例老年股骨轉子間骨摺患者資料,根據內固定方式不同分為兩組:InterTan髓內釘組(採用InterTan髓內釘內固定治療)25例,男9例,女16例；平均年齡為(78.4±6.1)歲,骨摺AO分型:A1型8例,A2型15例,A3型2例.Gamma 3釘組(採用Gamma 3釘內固定治療)25例,男7例,女18例；平均年齡為(79.2±7.8)歲；骨摺AO分型:A1型10例,A2型13例,A3型2例.記錄併比較兩組患者的手術時間、術中齣血量、骨摺愈閤時間、髖關節Harris評分及併髮癥的髮生情況. 結果 InterTan髓內釘組和Gamma 3釘組術後各有23例患者穫得隨訪,平均隨訪時間分彆為13.4、13.6箇月.InterTan髓內釘組和Gamma 3釘組患者手術時間平均分彆為(71.5±19.3)、(61.3±13.9) min,差異有統計學意義(t=0.120,P=0.044)；術中齣血量平均分彆為(183.9±69.3)、(182.1±68.8) mL,骨摺愈閤時間平均分彆為(3.1±0.8)、(3.1±0.6)箇月,髖關節Harris評分平均分彆為(83.7±5.7)、(82.2±6.4)分,併髮癥髮生率平均分彆為8.7％ (2/23)、13.0％ (3/23),以上項目兩組間比較差異均無統計學意義(P＞0.05). 結論 兩種內固定均可靠、效果良好,InterTan髓內釘更適閤骨質疏鬆嚴重或粉碎性骨摺患者,Gamma 3釘因手術時間短可用于對手術耐受較差的患者.
목적 비교InterTan수내정여Gamma3정치료노년고골전자간골절적림상료효.방법 회고성분석2010년5월지12월수치적50례노년고골전자간골절환자자료,근거내고정방식불동분위량조:InterTan수내정조(채용InterTan수내정내고정치료)25례,남9례,녀16례；평균년령위(78.4±6.1)세,골절AO분형:A1형8례,A2형15례,A3형2례.Gamma 3정조(채용Gamma 3정내고정치료)25례,남7례,녀18례；평균년령위(79.2±7.8)세；골절AO분형:A1형10례,A2형13례,A3형2례.기록병비교량조환자적수술시간、술중출혈량、골절유합시간、관관절Harris평분급병발증적발생정황. 결과 InterTan수내정조화Gamma 3정조술후각유23례환자획득수방,평균수방시간분별위13.4、13.6개월.InterTan수내정조화Gamma 3정조환자수술시간평균분별위(71.5±19.3)、(61.3±13.9) min,차이유통계학의의(t=0.120,P=0.044)；술중출혈량평균분별위(183.9±69.3)、(182.1±68.8) mL,골절유합시간평균분별위(3.1±0.8)、(3.1±0.6)개월,관관절Harris평분평균분별위(83.7±5.7)、(82.2±6.4)분,병발증발생솔평균분별위8.7％ (2/23)、13.0％ (3/23),이상항목량조간비교차이균무통계학의의(P＞0.05). 결론 량충내고정균가고、효과량호,InterTan수내정경괄합골질소송엄중혹분쇄성골절환자,Gamma 3정인수술시간단가용우대수술내수교차적환자.
Objective To compare clinical outcomes of InterTan and Gamma-3 nails in treatment of intertrochanteric fractures in the elderly.Methods We retrospectively compared the 50 old patients with intertrochanteric fracture who had been treated in our department from May to December 2010.Half of them were treated with InterTan nails and half with Gamma-3 nails.In the InterTan group,there were 9 men and 16 women,with an average age of 78.4 ± 6.1 years; there were 8 Al fractures,15 A2 ones and 2 A3 ones according to the AO classification.In the Gamma group,there were 7 men and 18 women,with an average age of 79.2 ±7.8 years; there were 10 A1 fractures,13 A2 ones and 2 A3 ones according to the AO classification.The 2 groups were compared in terms of operative time,intraoperative blood loss,fracture healing time,Harris hip score and complications.Results Twenty-three patients in each group were followed up for an average of 13.4 months and 13.6 months respectively.The operative time was 71.5 ± 19.3 minutes and 61.3 ± 13.9 minutes respectively for the InterTan and Gamma groups,with a significant difference (P ＜0.05).However,there were no significant differences between the 2 groups regarding blood loss (183.9 ± 69.3 mL vs.182.1 ±68.8 mL),fracture healing time (3.1 ±0.8 months vs.3.1 ±0.6 months),Harris hip score (83.7 ±5.7 points vs.82.2 ±6.4 points),or complication rate [8.7％ (2/23) vs.13.0％ (3/23)] (P ＞0.05).Conclusions Both InterTan and Gamma-3 nails can be used to treat femoral intertrochanteric fractures in the elderly patients,resulting in good clinical outcomes.InterTan nails may have a biomechanical advantage for patients with serious osteoporosis or comminuted fractures while Gamma-3 nails may be a better choice for patients with poor operative tolerance.
