CAJ | 학술논문

背景：随着股骨转子间骨折内固定方式选择的多样化，同一种类型骨折的内固定方式往往根据术者的习惯选择，无统一标准。目的：比较Gamma钉和股骨近端解剖锁定钛板置入内固定修复老年不稳定型股骨转子间骨折的优劣。方法：武警山西总队医院2009年4月至2012年9月对94例老年不稳定型股骨转子间骨折行内固定治疗，根据内固定方案分为两组，其中Gamma钉组46例，股骨近端锁定板组48例。从切口长度、术中出血量、手术时间、治疗后髋关节功能恢复情况、负重时间及并发症等方面对两种内固定方法进行对比分析。结果与结论：两种内固定方式在切口长度、术中出血量、治疗后负重时间及并发症方面比较，Gamma 钉优于股骨近端锁定板，差异有显著性意义(P <0.05)；两组患者手术时间差异无显著性意义(P >0.05)。治疗后1年髋关节功能 Gamma钉组优良率为96%(44/46)，股骨近端锁定板组优良率为92%(44/48)，两组差异无显著性意义(P >0.05)。提示Gamma钉和股骨近端解剖锁定钛板置入内固定修复不稳定型股骨转子间骨折均能实现良好的髋关节功能恢复，但 Gamma 钉在切口长度、术中出血量、治疗后并发症及负重时间等方面优势明显。
배경：수착고골전자간골절내고정방식선택적다양화，동일충류형골절적내고정방식왕왕근거술자적습관선택，무통일표준。목적：비교Gamma정화고골근단해부쇄정태판치입내고정수복노년불은정형고골전자간골절적우렬。방법：무경산서총대의원2009년4월지2012년9월대94례노년불은정형고골전자간골절행내고정치료，근거내고정방안분위량조，기중Gamma정조46례，고골근단쇄정판조48례。종절구장도、술중출혈량、수술시간、치료후관관절공능회복정황、부중시간급병발증등방면대량충내고정방법진행대비분석。결과여결론：량충내고정방식재절구장도、술중출혈량、치료후부중시간급병발증방면비교，Gamma 정우우고골근단쇄정판，차이유현저성의의(P <0.05)；량조환자수술시간차이무현저성의의(P >0.05)。치료후1년관관절공능 Gamma정조우량솔위96%(44/46)，고골근단쇄정판조우량솔위92%(44/48)，량조차이무현저성의의(P >0.05)。제시Gamma정화고골근단해부쇄정태판치입내고정수복불은정형고골전자간골절균능실현량호적관관절공능회복，단 Gamma 정재절구장도、술중출혈량、치료후병발증급부중시간등방면우세명현。
BACKGROUND:With the diversification of the choice of internal fixation for femoral intertrochanteric fracture, the fixation method for the same kind of fracture can be selected according to surgeon’s habit, and there is no unified standard. OBJECTIVE:To compare Gamma nail and proximal femoral locking plate fixation for repair of femoral intertrochanteric fractures. METHODS: A total of 94 elderly patients with unstable intertrochanteric fractures were treated in the Shanxi Armed Police Corps Hospital from April 2009 to September 2012. They were divided into two groups according to fixation methods. Gamma nail group contained 46 cases. Proximal femoral locking plate group contained 48 cases. The two fixation methods were compared and analyzed from the folowing aspects: incision length, intraoperative bleeding volume, operation time, postoperative hip function recovery, loading time and complications. RESULTS AND CONCLUSION:Incision length, intraoperative bleeding volume, loading time and complications were better in the Gamma nail group than in the proximal femoral locking plate group (P < 0.05). No significant difference in operation time was detected between the two groups (P > 0.05). The excelent and good rate of hip function was 96% (44/46) in the Gamma nail group and 92% (44/48) in the proximal femoral locking plate group at 1 year after treatment, and no significant difference was detectable between the two groups (P > 0.05). These findings suggest that Gamma nail and proximal femoral anatomic locking plate for the treatment of unstable intertrochanteric fractures can reach good recovery of hip function, but Gamma nail showed obvious advantages in incision length, intraoperative bleeding volume, loading time and complications.