CAJ | 학술논문

目的：观察加长Gamma3髓内钉闭合复位在股骨粗隆下粉碎性骨折中的应用效果。方法选择我院2010年1月~2013年12月收治的80例股骨粗隆下粉碎性骨折患者为研究对象，均行闭合复位治疗，随机将其分为治疗组（n=46），行加长Gamma 3髓内钉治疗，对照组（n=34）行动力髋螺钉治疗，术后随访12个月，比较两组手术结果、骨折愈合时间、功能恢复及并发症等情况。结果两组手术时间[（57.34±11.52）min vs（67.25±18.38）min]、术中出血量[（145.78±28.57）mL vs （264.55±25.26）mL]、住院时间[（14.20±2.63）d vs （18.65±3.00）d]及骨折愈合时间[（10.38±2.46）周 vs（14.21±2.24）周]比较，差异有统计学意义（P＜0.05）。另外随访1年，两组功能恢复优良率（91.30% vs 82.35%）比较，差异无统计学意义（P＞0.05），但两组并发症发生率（2.17% vs 17.65%）比较，差异有统计学意义（P＜0.05）。结论股骨粗隆下粉碎性骨折应用加长Gamma 3髓内钉闭合复位治疗，功能恢复良好，并发症少，值得临床推广。
목적：관찰가장Gamma3수내정폐합복위재고골조륭하분쇄성골절중적응용효과。방법선택아원2010년1월~2013년12월수치적80례고골조륭하분쇄성골절환자위연구대상，균행폐합복위치료，수궤장기분위치료조（n=46），행가장Gamma 3수내정치료，대조조（n=34）행동력관라정치료，술후수방12개월，비교량조수술결과、골절유합시간、공능회복급병발증등정황。결과량조수술시간[（57.34±11.52）min vs（67.25±18.38）min]、술중출혈량[（145.78±28.57）mL vs （264.55±25.26）mL]、주원시간[（14.20±2.63）d vs （18.65±3.00）d]급골절유합시간[（10.38±2.46）주 vs（14.21±2.24）주]비교，차이유통계학의의（P＜0.05）。령외수방1년，량조공능회복우량솔（91.30% vs 82.35%）비교，차이무통계학의의（P＞0.05），단량조병발증발생솔（2.17% vs 17.65%）비교，차이유통계학의의（P＜0.05）。결론고골조륭하분쇄성골절응용가장Gamma 3수내정폐합복위치료，공능회복량호，병발증소，치득림상추엄。
Objective To observe the application effect of extended Gamma 3 intramedullary nail close reduction in treatment of the subtrochanteric comminuted fracture. Methods A total of 80 cases of patients with subtrochanteric comminuted fracture treated in our hospital from January 2010 to December 2013 were selected as the research objects, and recieved closed reduction treatment, and they were randomly divided into the treatment group (n=46), which were given the treatment of extended Gamma 3 intramedullary nail, and the control group (n=34), which were given the treatment of dynamic hip screws. During the 12 months of postoperation follow up, the surgical results, fracture healing time, functional recovery and complications of the patients in two groups were compared. Results The operation time of two groups was (57.34±11.52) minutes vs (67.25±18.38) minutes, the amount of bleeding during operation was (145.78± 28.57) mL vs (264.55±25.26) mL, the time of hospitalization was (14.20±2.63) days vs (18.65±3.00) days and the time of fracture healing was (10.38 ±2.46) weeks vs (14.21 ±2.24)weeks. The differences were significant (P<0.05). In addi-tion, after one year of follow-up, the excellent rates of function recovery in two groups were 91.30%and 82.35%. There were no significant differences between them ( P>0 . 05 ) . The incidence of complications of the patients in the two groups were 2.17%and 17.65%. The differences were significant (P<0.05). Conclusion The subtrochanteric comminut-ed fracture is treated by closed reduction and application of extended Gamma 3 intramedullary nail, the functional re-covery of the patients is good and the complications are fewer. This method is worth the clinical promotion.