Aune A K, Ekeland A, Odegaard B, Grøgaard B, Alho A
Orthopedic Department, Ullevaal Hospital, University of Oslo, Norway.
Acta Orthop Scand. 1994 Apr;65(2):127-30. doi: 10.3109/17453679408995418.
A total of 378 trochanteric and subtrochanteric femoral fractures were randomized to treatment with Gamma nail (177) or Hip Compression Screw (HCS) (201). After a median follow-up time of 17 (10-27) months, 15 patients needed reoperations; 13 had been treated with Gamma nail and 2 with HCS. 10 patients, all treated with Gamma nail, were reoperated because of a femoral shaft fracture. 5 of these fractures occurred 8 (4-10) days postoperatively and were related to intraoperative complications. The other 5 shaft fractures occurred a median of 2 (1-3) months postoperatively after falls, and may be related to stress concentration at the tip of the solid nail. The lag screw cut out or penetrated the femoral head in 5 patients, 3 of them treated with Gamma nail and 2 with HCS.
共有378例股骨转子间和转子下骨折患者被随机分为两组，分别接受Gamma钉治疗（177例）或髋部加压螺钉（HCS）治疗（201例）。在中位随访时间17（10 - 27）个月后，有15例患者需要再次手术；其中13例接受Gamma钉治疗，2例接受HCS治疗。10例均接受Gamma钉治疗的患者因股骨干骨折而再次手术。这些骨折中有5例发生在术后8（4 - 10）天，与术中并发症有关。另外5例股骨干骨折发生在术后中位时间2（1 - 3）个月，是在跌倒后发生的，可能与实心钉尖端的应力集中有关。有5例患者的拉力螺钉穿出或穿透股骨头，其中3例接受Gamma钉治疗，2例接受HCS治疗。
