| 解剖型锁定钢板及Gamma钉治疗伴有外侧壁骨折股骨转子间骨折的病例对照研究 |
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投稿时间：2016-02-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 胡云根 |
HU Yun-gen |
浙江中医药大学附属江南医院, 杭州市萧山中医院骨科八病区, 浙江 杭州 311201 |
The 8th ward, Department of Orthopaedics, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical Univesity, Hangzhou 311201, Zhejiang, China |
hallen505@163.com |
| 韩雷 |
HAN Lei |
浙江中医药大学附属江南医院, 杭州市萧山中医院骨科八病区, 浙江 杭州 311201 |
The 8th ward, Department of Orthopaedics, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical Univesity, Hangzhou 311201, Zhejiang, China |
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| 方伟利 |
FANG Wei-li |
浙江中医药大学附属江南医院, 杭州市萧山中医院骨科八病区, 浙江 杭州 311201 |
The 8th ward, Department of Orthopaedics, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical Univesity, Hangzhou 311201, Zhejiang, China |
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| 金波 |
JIN Bo |
浙江中医药大学附属江南医院, 杭州市萧山中医院骨科八病区, 浙江 杭州 311201 |
The 8th ward, Department of Orthopaedics, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical Univesity, Hangzhou 311201, Zhejiang, China |
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| 期刊信息：《中国骨伤》2016年，第29卷，第6期，第496-501页 |
| DOI：10.3969/j.issn.1003-0034.2016.06.003 |
| 基金项目: |
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| 中文摘要:目的: 比较解剖型锁定钢板与Gamma钉治疗伴有外侧壁骨折的不稳定性转子间骨折的临床疗效。方法: 回顾性分析2010年6月至2014年6月采用解剖型锁定钢板和Gamma 钉内固定治疗伴有外侧壁骨折的不稳定性转子间骨折(AO 31A2.2-3.3)且随访超过12个月的患者44例。其中采用解剖型锁定钢板内固定治疗的患者16例,男6例,女10例;年龄32～83岁,平均56.5岁。采用Gamma 钉内固定治疗的患者28例,男17例,女11例;年龄26～87岁,平均60.4岁。观察并比较两组患者的手术时间、术中透视次数、总失血量(术中+隐性失血)、住院天数,术后疗效采用PPMS(Parker Palmer mobility score,PPMS)及HSS(Harris hip score,HHS)髋关节功能评分标准进行评价。结果: 所有患者获得随访,时间12～24个月,平均16.2个月。Gamma钉组手术时间低于解剖锁定钢板组;解剖锁定钢板组失血量(术中+隐性失血)及术中透视次数少于Gamma钉组;两组患者住院天数比较差异无统计学意义;术后首次完全负重时间解剖锁定钢板组较Gamma钉组延长;末次随访时Gamma钉组PPMS评分(7.50±1.78)与解剖锁定钢板组(6.82±1.38)比较差异无统计学意义(t=2.341,P=0.132);Gamma钉组HHS评分(83.25±11.18)与锁定钢板组(86.14±12.36)比较差异无统计学意义(t=1.923,P=0.243);Gamma钉术后内固定并发症发生率低于解剖型锁定钢板组。结论: 解剖型锁定钢板治疗伴有外侧壁骨折的不稳定性转子间骨折可避免外侧壁再次损伤,尤其对骨折严重粉碎、髓内钉操作困难患者,同Gamma钉相比术后髋关节功能无显着差异,但术后并发症发生率高于Gamma钉,不应强调过早负重。 |
| 【关键词】股骨 骨折 骨折固定术 病例对照研究 |
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| Comparison of anatomical locking plate and Gamma nail for the treatment of intertrochanteric fracture with external wall fractures |
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| ABSTRACT Objective: To compare clinical efficacy of anatomic locking plate and Gamma nail in treating unstable femoral intertrochanteric fractures with external wall fractures. Methods: From June 2010 to June 2014,clinical data of 44 patients with intertroehanteric fractures associated with lateral wall fractures(type 31A2.2-3.3) followed more than 12 months,which treated with Gamma nail or anatomic locking plate,were retrospective analyzed. Sixteen patients were treated with anatomic locking plate,including 6 males and 10 females aged from 32 to 83 years old with an average of 56.5 years old. Twenty-eight patients were treated with Gamma nail including 17 males and 11 females aged from 26 to 87 years old with an average of 60.4 years old. Operative time,intraoperative fluoroscopy times,blood loss(intraoperative and hidden blood loss),hospital stays were observed and compared. PPMS and HHS scoring were used to evaluate postoperative clinical effect. Results: All patients were followed up from 12 to 24 months with an average of 16.2 months. Operative time in Gamma nail was shorter than anatomic locking plate;while blood loss( intraoperative and hidden blood loss) and intraoperative fluoroscopy times in anatomic locking plate were less than that of in Gamma nail. There was no significant meaning in hospital stays between two groups. Postoperative full weight-bearing time in anatomic locking plate was prolonged than Gamma nail. At the final following-up,PPMS in Gamma nail was 7.50±1.78,and 6.82±1.38 in anatomic locking plate,and there was no obvious meaning between two groups(t=2.341,P=0.132); there was no significant differences in HHS score between Gamma nail(83.25±11.18) and anatomic locking plate (86.14±12.36)(t=1.923,P=0.243). The incidence of complications in Gamma nail was less than anatomic locking plate (P=0.005). Conclusion: Anatomic locking plate for intertrochanteric fractures with external wall fractures could avoid re-injury of external wall,especially for severe comminuted fractures,difficult for intramedullary nailing,and there was no significant meaning in hip joint function compared with Gamma nail,while postoperative incidence of complications was higher than Gamma nail,so early weight-bearing was not stress. |
| KEY WORDS Femur Fractures Fracture fixation 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: | 胡云根,韩雷,方伟利,金波.解剖型锁定钢板及Gamma钉治疗伴有外侧壁骨折股骨转子间骨折的病例对照研究[J].中国骨伤,2016,29(6):496~501 |
| 英文格式: | HU Yun-gen,HAN Lei,FANG Wei-li,JIN Bo.Comparison of anatomical locking plate and Gamma nail for the treatment of intertrochanteric fracture with external wall fractures[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(6):496~501 |
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