CAJ | 학술논문

背景:股骨转子间骨折的固定治疗方法有髓内固定和髓外固定,各有优劣.目的:探讨动力髋螺钉与新一代股骨近端髓内钉治疗不同分型的股骨转子间骨折的疗效差异.方法:2010年7月至2011年12月收治84例股骨转子间骨折患者,骨折按 Evans 分型:Ⅰa 型及Ⅰb 型共43例患者进行动力髋螺钉内固定;Ⅰc 型及Ⅰd 型共41例患者进行股骨近端髓内钉内固定.结果与结论:84例患者均获得随访,平均随访时间11.6个月,所有患者均骨折愈合.两组患者骨折愈合时间,下床活动时间及末次随访 Harris 评分差异均无显著性意义(P >0.05).动力髋螺钉组末次随访 Harris 评分为(87.7±9.3)分,优良率83.7%;新一代股骨近端髓内钉组末次随访 Harris 评分为(85.9±8.6)分,优良率90.2%.两组末次随访Harris 评分和优良率差异无显著性意义(P >0.05).证实,在股骨转子间骨折内固定的植入物选择时,Evans Ⅰa 及Ⅰb 型骨折者适合采用动力髋螺钉定,Evans Ⅰc 及Ⅰd 型骨折适合选择新一代股骨近端髓内钉,两种螺钉植入后疗效均显著,且效果相当.
배경:고골전자간골절적고정치료방법유수내고정화수외고정,각유우렬.목적:탐토동력관라정여신일대고골근단수내정치료불동분형적고골전자간골절적료효차이.방법:2010년7월지2011년12월수치84례고골전자간골절환자,골절안 Evans 분형:Ⅰa 형급Ⅰb 형공43례환자진행동력관라정내고정;Ⅰc 형급Ⅰd 형공41례환자진행고골근단수내정내고정.결과여결론:84례환자균획득수방,평균수방시간11.6개월,소유환자균골절유합.량조환자골절유합시간,하상활동시간급말차수방 Harris 평분차이균무현저성의의(P >0.05).동력관라정조말차수방 Harris 평분위(87.7±9.3)분,우량솔83.7%;신일대고골근단수내정조말차수방 Harris 평분위(85.9±8.6)분,우량솔90.2%.량조말차수방Harris 평분화우량솔차이무현저성의의(P >0.05).증실,재고골전자간골절내고정적식입물선택시,Evans Ⅰa 급Ⅰb 형골절자괄합채용동력관라정정,Evans Ⅰc 급Ⅰd 형골절괄합선택신일대고골근단수내정,량충라정식입후료효균현저,차효과상당.
BACKGROUND: The intramedul ary and extramedul ary fixations are two main surgical treatment methods for intertrochanteric fractures, each method has the advantages and disadvantages. OBJECTIVE: To investigate the different effect of dynamic hip screw and the new generation of the femur proximal femoral nail (InterTan) in the treatment of different sub-type of intertrochanteric fractures. METHODS: A series of 84 cases of intertrochanteric fractures were fixed by dynamic hip screw and InterTan during July 2010 to December 2011. According to Evans classification, 43 patients of type Ⅰa and type Ⅰb were treated with dynamic hip screw, and 41 patients of type Ⅰc and type Ⅰd were treated with InterTan nails. RESULTS AND CONCLUSION: Eighty-four patients were fol owed-up for an average of 11.6 months, al patients were fracture healing. There was no significant difference in healing time, get out of bed time and the last fol ow-up Harris hip score between two groups (P > 0.05). The last fol ow-up Harris hip score in the dynamic hip screw group was (87.7±9.3) points, and the excel ent and good rate was 83.7%; The last fol ow-up Harris score in the InterTan group was (85.9±8.6) points, the excel ent and good rate was 90.2%. There was no significant difference of last fol ow-up Harris hip score between two groups (P > 0.05). During the choice of internal fixation materials, patients with Evans type Ⅰa and typeⅠb should be treated with dynamic hip screw, and the patients with Evans type Ⅰc and type Ⅰd should be treated with InterTan nail. Both dynamic hip screw and InterTan have a positive effect and the effect is similar.