He Sheng-hua, Peng Jun-yu, Zhao Xiang
Department of Orthopaedics, Tradiitonal Chinese Medical Hospital of Wuhu, Wuhu 241001, Anhui, China.
Zhongguo Gu Shang. 2009 Jan;22(1):6-9.
To investigate the therapeutic effect on femoral intertrochanteric fracture for three kinds of treatment methods and make theoretical analysis to offer basis on choosing the proper treatment method in clinic.
We retrospectively reviewed the clinical and radiological records of 198 patients with femoral intertrochanteric fracture for three kinds of different treatment: unilateral external fixation apparatus (51 cases), dynamic hip screw (57 cases), internal fixation of Gamma nail (90 cases) from January 2001 to October 2006. The union of fracture and weight loading time, the averages length of stay,the incidence of complications,the functional evaluation of hip joint (the rate of excellent and good results) were compared and the curative effects were analyzed in different methods.
All the patients were followed-up for 36 months in average (from 8 months to 51 months). The union of fracture time were no statistically significant among the three groups (P>0.05). The weight loading time and incidence of complications were statistical significance among the three groups (P<0.05). Among the three groups,the incision length, operation time,blood loss and drainage in dynamic hip screw group were more than other groups, the unilateral external fixation apparatus group were less, Gamma nail group were in moderate. According to the Sanders' hip functional standard score,there were significant difference between the Gamma nail group and the other two groups (compared with dynamic hip screw group, P<0.05; compared with unilateral external fixation apparatus group, P<0.01).
The internal fixation of Gamma nail is a good choice for treating femoral intertrochanteric fracture. The weight loading time is earlier,the recovery of hip joint function is better,the incidence of complications is less in Gamma nail group than other two groups.
探讨三种治疗方法对股骨粗隆间骨折的治疗效果，并进行理论分析，为临床选择合适的治疗方法提供依据。
回顾性分析2001年1月至2006年10月间198例股骨粗隆间骨折患者采用三种不同治疗方法的临床及影像学资料，包括单侧外固定架固定（51例）、动力髋螺钉固定（57例）、Gamma钉内固定（90例）。比较不同治疗方法的骨折愈合时间、负重时间、平均住院时间、并发症发生率、髋关节功能评价（优良率），并分析疗效。
所有患者平均随访36个月（8个月至51个月）。三组骨折愈合时间差异无统计学意义（P>0.05）。三组负重时间及并发症发生率差异有统计学意义（P<0.05）。三组中，动力髋螺钉组切口长度、手术时间、出血量及引流量均多于其他两组，单侧外固定架组最少，Gamma钉组居中。根据Sanders髋关节功能标准评分，Gamma钉组与其他两组差异有统计学意义（与动力髋螺钉组比较，P<0.05；与单侧外固定架组比较，P<0.01）。
Gamma钉内固定是治疗股骨粗隆间骨折的较好选择。Gamma钉组负重时间早，髋关节功能恢复好，并发症发生率低于其他两组。
