| 股骨近端锁定钢板与Gamma钉治疗老年股骨转子间骨折的病例对照研究 |
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投稿时间：2012-04-19
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| 作者 | Author | 单位 | Address | E-Mail |
| 韩贵和 |
HAN Gui-he |
浙江中医药大学附属中西医结合医院骨伤科,浙江 杭州 310003 |
Affiliated Clinical Hospital of Integrated Traditional and Western Medicine of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310003,Zhejiang,China |
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| 魏威 |
WEI Wei |
浙江中医药大学附属中西医结合医院骨伤科,浙江 杭州 310003 |
Affiliated Clinical Hospital of Integrated Traditional and Western Medicine of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310003,Zhejiang,China |
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| 顾军 |
GU Jun |
浙江中医药大学附属中西医结合医院骨伤科,浙江 杭州 310003 |
Affiliated Clinical Hospital of Integrated Traditional and Western Medicine of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310003,Zhejiang,China |
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| 期刊信息：《中国骨伤》2012年，第25卷，第10期，第796-799页 |
| DOI：10.3969/j.issn.1003-0034.2012.10.002 |
| 基金项目: |
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中文摘要:
目的：探讨股骨近端锁定钢板和Gamma钉治疗老年股骨转子间骨折的临床疗效.
方法：自2008年6月至2010年6月收治股骨转子间骨折83例,分为2组:A组42例,男23例,女19例;年龄64～92岁;按Jensen分型,Ⅱ型19例,Ⅲ型17例,Ⅳ型4例,Ⅴ型2例,采用股骨近端锁定钢板固定治疗.B组41例,男24例,女17例;年龄65～90岁;按Jensen分型,Ⅱ型20例,Ⅲ型16例,Ⅳ型3例,Ⅴ型2例,采用Gamma钉固定治疗.比较两组患者手术时间、术中失血量、术后血红蛋白(Hb)减少量、骨折愈合时间,术后疗效采用Parker-Palmer评分进行评判.
结果：所有患者获随访,时间8～12个月,平均(10.6±2.4)个月.A组手术时间平均(62.46±21.61)min,术中失血量50～260 ml,术后第2天血红蛋白化验值与术前的差值平均(18.2±6.25) g/L,骨折愈合时间12～24周,Parker-Palmer活动评分平均(7.68±1.09)分;B组手术时间平均(67.42±19.46) min,术中失血量40～280 ml,术后第2天血红蛋白化验值与术前的差值平均(40.14±8.62)g/L,骨折愈合时间14～22周,Parker-Palmer评分平均为(7.59±1.12)分.两组手术时间(t=-1.78,P>0.05),术中失血量(Z=-0.65,P>0.05),骨折愈合时间(Z=-0.72,P>0.05),Parker-Palmer评分(t=1.83,P>0.05)比较差异均无统计学意义.A组手术前后血红蛋白减少量小于B组(t=-2.63,P<0.05).
结论：股骨近端锁定钢板方法具有术后出血量少、固定相对牢固的优点,适用于老年股骨转子间骨折的内固定治疗. |
| 【关键词】骨折固定术,内 股骨骨折 骨折愈合 病例对照研究 |
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| Comparison of proximal femoral locking plate and Gamma nail in the treatment of the femoral intertrochanteric fractures in the elder |
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ABSTRACT
Objective:To evaluate and compare the clinical effects of proximal femoral locking plate with Gamma nail in the treatment of the femoral intertrochanteric fractures in the elder.
Methods:From June 2008 to June 2010,83 patients with femoral intertrochanteric fracture were randomly divided into two groups(group A and group B). In group A,there were 42 cases including 23 males and 19 females,the range of their age was from 64 to 92 years old;according to Jensen classification,there were 19 cases of type Ⅱ fracture,17 of type Ⅲ fracture,4 of type Ⅳ fracture,2 of type Ⅴ fracture. In group B,there were 41 cases including 24 males and 17 females,the range of their age was from 65 to 90 years old;20 cases were type Ⅱ,16 cases were type Ⅲ,3 cases were type Ⅳ,2 cases were type Ⅴ. The patients of group A were treated with locking plate,the patients of group B with Gamma nail. The observing and comparing items of the two groups included ①After the operation,the operational duration was assessed; ②After the operation,intraoperative bleeding volume was assessed; ③Hemoglobin reduction was assessed in second day after the operation;④At the last follow-up,fracture healing time was assessed. ⑤Functional recovery was evaluated according to Parker and Palmer mobility score.
Results:All patients were followed-up for 10.6 months in average (ranging from 8 to 12). In group A,the average operation time was (62.46±21.61) min,the range of intraoperative bleeding volume was from 50 to 260 ml,the average hemoglobin reduction after the operation was(18.20±6.25) g/L,the rang of fracture healing time was from 12 to 24 weeks and the average Parker-Palmer mobility score was(7.68±1.09) points. In group B,the average operation time was(67.42±19.46) min,the range of intraoperative bleeding volume was from 40 to 280 ml,the average hemoglobin reduction after the operation was (40.14±8.62) g/L,the rang of fracture healing time was from 14 to 22 weeks and the average Parker-Palmer mobility score was (7.59±1.12) points. There were no statistically significant differences(P > 0.05) between two groups for the average operation time,the volume of intraoperative bleeding and Park and Palmer mobility score. Hemoglobin reduction after the operation in group A was less than in group B,there were statistically significant differences(P < 0.05) between two groups.
Conclusion:The method of proximal femoral locking plate had advantages of less bleeding after operation and relative strong fixing in the femoral intertrochanteric fractures,was more suitable for the femoral intertrochanteric fracture in the elder. |
| KEY WORDS Fracture fixation,internal Femoral fractures Fracture healing Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 韩贵和,魏威,顾军.股骨近端锁定钢板与Gamma钉治疗老年股骨转子间骨折的病例对照研究[J].中国骨伤,2012,25(10):796~799 |
| 英文格式: | HAN Gui-he,WEI Wei,GU Jun.Comparison of proximal femoral locking plate and Gamma nail in the treatment of the femoral intertrochanteric fractures in the elder[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(10):796~799 |
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