摘要
目的对比分析股骨近端解剖型锁定加压钢板（locking compression plate,LCP）与动力髋螺钉（dynamic hipscrew,DHS）、Gamma钉内固定治疗股骨粗隆间骨折的手术效果及并发症情况。方法选择2009年12月～2011年12月茂名市中医院骨科收治的72例股骨粗隆间骨折患者作为观察对象,其中,30例行LCP内固定（Ⅰ组）,22例行DHS内固定（Ⅱ组）,20例行Gamma钉内固定（Ⅲ组）。比较三组患者的临床骨折愈合时间、术后随访3、6、12的Harris评分变化情况及早、晚期并发症情况。结果Ⅰ组出血量为（349.02±56.38）mL,明显低于Ⅱ组;Ⅰ组的骨折临床愈合时间为（8.63±1.87）周,明显短于Ⅱ、Ⅲ组,差异有统计学意义（P〈0.05）;术后12个月,Ⅰ组的Harris评分明显高于其他各组,差异有统计学意义（P〈0.05）,且术后12个月,Ⅰ组的Harris评分较术后3及6个月均明显升高,差异有统计学意义（P〈0.05）。Ⅰ组出现下肢深静脉血栓1例,经抗凝治疗后好转。Ⅰ组并发症发生率最低（3.3%）,明显低于Ⅱ、Ⅲ组,差异有统计学意义（P〈0.05）。结论与其他内固定方法比较,LCP内固定操作简便、手术时间短、创伤小、出血量少、并发症少,值得临床推广和应用。
Objective To compare the surgical effects and complications of the proximal femur locking compression plate （LCP）, dynamic hip screw （DHS）, Gamma nail fixation in the treatment of intertrochanteric fractures. Methods 72 cases of patients with intertrochanteric fractures treated in Hospital of Traditional Chinese Medicine in Maoming City from December 2009 to December 2011 were selected as the observed objects, of which 30 cases were given LCP internal fixation treatment （Ⅰ group）, 22 cases were given DHS internal fixation treatment （Ⅱ group）, 20 cases were given Gamma nail internal fixation treatment （Ⅲ group）. The clinical fracture healing time, Harris score changes after following-up for 3, 6, 12 months, and early and late complications were compared. Results The amount of bleeding in group I was （349.02±56.38） mL, which was significantly lower than that in the group U. The fracture healing time in group I was （8.63±1.87） weeks, which was significantly shorter than that in the group Ⅱ and group Ⅲ, with statistically significant differences （P 〈 0.05）. After 12 months follow up, Harris score of group I was significantly higher than the other groups, with statistically significant differences （P 〈 0.05）, while after 12 months follow up, Harris score of the group I significantly increased than 3 and 6 months after surgery, with statistically significant differences （P 〈 0.05）. There was 1 case with deep venous thrombosis in group I , who was improved after anticoagulant therapy. The occurrence rate of complication in group I was the lowest （3.3%）, which was significantly lower than that in group Ⅱ and group Ⅲ, with statistically significant differences （P 〈 0.05）. Conclusion Compared with other internal fixation methods, the operation of LCP internal fixation is simple, which has shorter operative time, less trauma, less blood loss, fewer complications. It is worthy of clinical application.
出处
《中国医药导报》
CAS
2013年第20期48-50,57,共4页
China Medical Herald
基金
广东省茂名市医学科技计划项目(编号20102062)
