摘要
目的探讨不同内固定方法治疗股骨转子间骨折的手术指征与临床疗效。方法2004年12月至2007年12月收治的股骨转子间骨折并通过手术治疗的57例,分别采用Gamma钉、动力髋螺钉(DHS)及股骨近端髓内钉(PFN)对不同类型的股骨转子间骨折行内固定。按骨折愈合情况,对髋关节疗效评分标准进行评分。结果57例随访1～2年,采用Gamma钉固定18例:优良率94.4%,DHS固定20例:优良率95.0%,PFN固定19例:优良率94.7%。结论3种不同方法内固定治疗转子间骨折具有各自的特点,Gamma钉具有手术损伤小及良好的临床疗效力臂短对抗髋内翻的能力强,适用于Ⅰ～Ⅱ型及不能耐受较大手术者;DHS具有良好的临床疗效及相对坚强的抗内翻能力,但手术损伤相对较大,失血量较大,适用于Ⅰ～Ⅳ型骨折,较适宜于青壮年患者;PFN固定的手术损伤最小,属于微创手术方法,手术出血少,适用于高龄及骨质疏松的患者。
Objective To discuss the operation indications and effects of different internal fixation of femoral peritrochantefic fracture. Methods 57 cases with femoral peritroehanteric fracture from December, 2004 to December,2007.18 were treated by Gamma nail ,20 of them were treated by dynamic hip screw（ DHS）, and 19 of them were treated by proximal femoral nail（PFN）. Score in terms of fracture union and score standards of the treatment for hip after treatment. Results 57 cases were followed up for one or two years. The excellent rate in the 18 cases treated by Gamma nail was 94.4% ,95.0%was excellent in the 20 cases treated by DHS, and 94. 7% in the 19 cases treated by PFN. Conclusion These three intern fixations of femoral peritrochanteric fracture were different. For example, Gamma nail is less harmful, better clinical treatment, shorter in shape and stronger in anti-hip inversion and is suitful for type Ⅰ and Ⅱ fractures Evans classification patients and who don＇t tolerate bigger operation. DHS have a better treatment and are stronger in anti-hip inversion but more harmful and excessive bleeding, and is suitable for type Ⅰ to Ⅳ and young adult patient. PFN, which is the least harmful,less bleeding,is suitable for old patients and the patients with osteoporosis.
出处
《中国实用医药》
2009年第3期28-30,共3页
China Practical Medicine
关键词
股骨转子间骨折
内固定
临床评价
Peritrochanteric fracture
Internal fixations
Clinical assessment
