摘要
目的观察60岁以上老年转子间骨折的Gamma钉治疗效果,同时与传统的动力髋部螺钉(DHS)固定方法比较,评价Gamma钉临床应用的优、缺点和注意事项。方法收集近10年来60岁以上老年转子间骨折住院手术并获随访1年以上病例166例,其中DHS治疗129例,Gamma钉治疗37例,对手术操作时间、失血量、输血量、术后血红蛋白降低量和术后1年的生活质量进行逐项总结和比较。结果两组的平均手术时间、术中失血量及血红蛋白的变化有显著差异(P<0.01)。一年后的功能恢复情况和生活质量统计显示Gamma钉和DHS手术,分别只有56.7%和55.2%能完全恢复到伤前水平,分别有37.8%和36.4%及5.4%和8.3%功能不如伤前或生活不能自理。两者结果的差异无显著性。结论Gamma钉治疗老年转子间骨折有方法简单、手术时间短、伤口暴露小等优点。但其潜在的创伤并不比传统的DHS方法小,这两种方法对老年人生活质量也仅有55.2%～56.7%得到较好的改善。
Objective To observe the clinical results of Gamma nails in treatment of intertrochanteric fractures in patients over 60 years old and evaluate the clinical advantages and disadvantages of Gamma nails in comparison of traditional DHS(dynamic hip screw). Methods We collected the clinical data of 166 cases of over 60 years old who had been hospitalized and operated on in the last 10 years. Of them, 129 cases were fixed with DHS and 37 cases with Gamma nails. We analyzed and compared the cases with respect to hospitaliztion time before operation, operation time, amount of blood loss and blood transfusion, amount of hemoglobin decreasing and life quality of 1 year after operation. Results In the 2 groups, average operation time, amount of blood loss and amount of hemoglobin decreasing were statistically different(P< 0.01). 57.6%of Gamma nail cases and 55.2%of DHS ones completely recovered to the physical situation before trauma. 37.8%of Gamma nail cases and 36.4%of the DHS ones experienced partial loss of the function. 5.4%of the Gamma nail cases and 8.3%of the DHS ones were disabled. There was no significant difference between Gamma nails and DHS in functional recovery and life quality 1 year after operation. Conclusions The advantages of Gamma nails in treating intertrochanteric fractures are simple manipulation, short operation time, and small exposure, but they cause great internal damage to bone and do not improve the life quality and function for old patients compared with traditional DHS. Although Gamma nails are a good device for intertrochanteric fractures, but the design needs to be further improved so as to control extra operative damage.
出处
《中华创伤骨科杂志》
CAS
CSCD
2004年第9期963-965,共3页
Chinese Journal of Orthopaedic Trauma
关键词
GAMMA钉
转子间骨折
骨折固定术
内
老年
Gamma nail
Intertrochanteric fracture
Fracture fixation,internal
The aged
