Fan Wenbin, Shi Liu, Xie Tian, Zhang Cheng, Chen Xiangxu, Chen Hui, Rui Yunfeng
Department of Orthopaedics, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P. R. China.
Trauma Center, Zhongda Hospital Southeast University, Nanjing Jiangsu, 210009, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Jan 15;39(1):47-52. doi: 10.7507/1002-1892.202407041.
To compare the short-term effectiveness between Gamma 3 intramedullary nails and Gamma 3 U-Blade system in the treatment of osteoporotic intertrochanteric fractures in the elderly.
A retrospective analysis was conducted on the clinical data of 124 elderly patients with osteoporotic intertrochanteric fractures, who were admitted between February 2020 and February 2023 and met the selection criteria. The fractures were fixed with Gamma 3 intramedullary nails in 65 patients (control group) and Gamma 3 U-Blade systems in 59 patients (UB group). The differences between the two groups were not significant in age, gender, body mass index, American Society of Anesthesiologists (ASA) classification, bone mineral density, time from injury to operation, fracture classification, and affected side ( >0.05). The operation time, intraoperative blood loss, hospital stay, and fracture healing time were recorded; the tip-apex distance, fracture reduction quality, and lag screw position were evaluated on X-ray films at immediate after operation; the lag screw sliding distance and change value of neck-shaft angle were measured on X-ray films at last follow-up. Harris hip score at 1 year after operation and the occurrence of internal fixation-related complications were compared between the two groups.
The operation time, intraoperative blood loss, and hospital stay in the UB group increased compared to the control group, but the differences were not significant ( >0.05). All patients in both groups were followed up 12-24 months (mean, 17.1 months). At 12 months after operation, there was no significant difference in the Harris hip score between the two groups ( <0.05). Radiological examination showed that there was no significant difference between the two groups ( >0.05) in terms of tip-apex distance, fracture reduction quality, and lag screw position. Fractures healed in both groups, and there was no significant difference in healing time ( >0.05). At last follow-up, the change value of neck-shaft angle and lag screw sliding distance in the UB group were significantly lower than those in the control group ( <0.05). During follow-up, no related complications occurred in the UB group, while 6 cases (9.2%) in the control group experienced complications, and the difference in the incidence was significant ( <0.05).
For the osteoporotic intertrochanteric fractures in the elderly, the Gamma 3 U-Blade system fixation can achieve good short-term effectiveness, with better imaging results compared to Gamma 3 intramedullary nails fixation.
比较Gamma 3髓内钉与Gamma 3 U型钢板系统治疗老年骨质疏松性股骨转子间骨折的短期疗效。
回顾性分析2020年2月至2023年2月收治的124例符合入选标准的老年骨质疏松性股骨转子间骨折患者的临床资料。65例患者(对照组)采用Gamma 3髓内钉固定骨折,59例患者(UB组)采用Gamma 3 U型钢板系统固定。两组在年龄、性别、体重指数、美国麻醉医师协会(ASA)分级、骨密度、受伤至手术时间、骨折分型及患侧等方面差异无统计学意义(>0.05)。记录手术时间、术中出血量、住院时间及骨折愈合时间;术后即刻通过X线片评估尖顶距、骨折复位质量及拉力螺钉位置;末次随访时通过X线片测量拉力螺钉滑动距离及颈干角变化值。比较两组术后1年的Harris髋关节评分及内固定相关并发症的发生情况。
UB组的手术时间、术中出血量及住院时间较对照组增加,但差异无统计学意义(>0.05)。两组患者均获随访12 - 24个月(平均17.1个月)。术后12个月时,两组Harris髋关节评分差异无统计学意义(<0.05)。影像学检查显示,两组在尖顶距、骨折复位质量及拉力螺钉位置方面差异无统计学意义(>0.05)。两组骨折均愈合,愈合时间差异无统计学意义(>0.05)。末次随访时,UB组的颈干角变化值及拉力螺钉滑动距离均显著低于对照组(<0.05)。随访期间,UB组未发生相关并发症,而对照组有6例(9.2%)发生并发症,发生率差异有统计学意义(<0.05)。
对于老年骨质疏松性股骨转子间骨折,Gamma 3 U型钢板系统固定可取得良好的短期疗效,与Gamma 3髓内钉固定相比,影像学结果更佳。