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股骨近端防旋髓内钉与 Gamma3 钉治疗不稳定型转子间骨折的髓内钉固定:一项随机对照研究。

Proximal Femoral Nail Antirotation versus Gamma3 nail for intramedullary nailing of unstable trochanteric fractures. A randomised comparative study.

机构信息

Department of Orthopaedic and Trauma Surgery, Hospital General Universitario Gregorio Maranon, Madrid, Spain.

出版信息

Injury. 2012 Dec;43 Suppl 2:S47-54. doi: 10.1016/S0020-1383(13)70179-7.

Abstract

The purpose of this study was to compare the clinical results and the complication rates of a new generation of two intramedullary fixation devices: Proximal Femoral Nail Antirotation® (PFNA) and Gamma3®. We conducted a prospective randomised multicentre trial of 61 patients who underwent a PFNA fixation treatment (31 patients) or a Gamma3 nail (30 patients). We documented the fixation failure complications as well as data of the surgical procedure, the clinical and functional outcomes (the EuroQoL5 questionnaire, the Katz index score, the Short Form 36 (SF-36), and the Harris Hip Score) and the plain radiographic parameters at 3,6 and 12 months follow up. The PFNA and Gamma3 fixation devices were similar in terms of complication rates. The risk for experiencing a postoperative complication after Gamma3 nailing was 40% versus 45% after PFNA fixation. At the 6-month and 1-year follow-up evaluations, there were no significant differences in terms of range of motion, clinical scores and radiological outcomes.

摘要

本研究旨在比较新一代两种髓内固定装置的临床结果和并发症发生率

股骨近端防旋髓内钉(PFNA)和 Gamma3 钉。我们进行了一项前瞻性随机多中心试验,纳入了 61 例接受 PFNA 固定治疗(31 例)或 Gamma3 钉治疗(30 例)的患者。我们记录了固定失败的并发症以及手术过程、临床和功能结果(EuroQoL5 问卷、Katz 指数评分、SF-36 简短量表和 Harris 髋关节评分)以及术后 3、6 和 12 个月随访的影像学参数。PFNA 和 Gamma3 固定装置的并发症发生率相似。Gamma3 钉术后发生并发症的风险为 40%,PFNA 固定术后为 45%。在 6 个月和 1 年的随访评估中,在运动范围、临床评分和影像学结果方面均无显著差异。

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