Habernek H, Schmid L, Frauenschuh E
Trauma Department, Landeskrankenhaus, Bad Ischl, Austria.
Br J Sports Med. 2000 Feb;34(1):54-8. doi: 10.1136/bjsm.34.1.54.
In an eight year period, 31 patients with proximal femoral fractures resulting from sports accidents were treated by implantation of either a Gamma nail or a dynamic hip screw. Return to work or sports and the time to bone healing did not differ very much between the treatments. Gamma nailing was clearly the best with regard to stability and time to full mobilisation (4.5 days), but required 39 minutes to perform compared with insertion of a dynamic hip screw (27 minutes). The incidence of complications and malalignments did not differ very much between the two, although, when Gamma nailing was first used in the authors' clinic, more intraoperative complications occurred than with the dynamic hip screw. Stable pertrochanteric fractures may be treated with a dynamic hip screw. Unstable pertrochanteric or subtrochanteric fractures are treated with a Gamma nail at the authors' institution.
在八年的时间里，31例因运动事故导致股骨近端骨折的患者接受了Gamma钉或动力髋螺钉植入治疗。两种治疗方法在恢复工作或运动以及骨折愈合时间方面差异不大。在稳定性和完全活动时间（4.5天）方面，Gamma钉显然是最佳选择，但与动力髋螺钉植入（27分钟）相比，其植入操作需要39分钟。两种治疗方法的并发症和畸形发生率差异不大，不过，当Gamma钉首次在作者所在诊所使用时，术中并发症比动力髋螺钉更多。稳定的转子间骨折可用动力髋螺钉治疗。在作者所在机构，不稳定的转子间或转子下骨折则用Gamma钉治疗。
