| 股骨粗隆间骨折3种不同手术方式的病例对照研究 |
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Received:August 27, 2008
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| 作者 | Author | 单位 | Unit | E-Mail |
| 何升华 |
HE Sheng-hua |
芜湖市中医医院骨科,安徽 芜湖 241001 |
Department of Orthopaedics,Tradiitonal Chinese Medical Hospital of Wuhu,Wuhu 241001,Anhui,China |
heshenghua99@163.com |
| 彭俊宇 |
PENG Jun-yu |
芜湖市中医医院骨科,安徽 芜湖 241001 |
Department of Orthopaedics,Tradiitonal Chinese Medical Hospital of Wuhu,Wuhu 241001,Anhui,China |
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| 赵祥 |
ZHAO Xiang |
芜湖市中医医院骨科,安徽 芜湖 241001 |
Department of Orthopaedics,Tradiitonal Chinese Medical Hospital of Wuhu,Wuhu 241001,Anhui,China |
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| 期刊信息：《中国骨伤》2009年22卷，第1期，第6-9页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：分析单边外固定支架、动力髋螺钉(dynamic hip screw,DHS) 与Gamma钉内固定治疗股骨粗隆间骨折的疗效，为临床选择适当的治疗方法提供依据。
方法： 2001年1月至2006年10月，采用单边外固定支架、DHS、Gamma钉内固定3种方法治疗198例股骨粗隆间骨折患者。采用回顾性方法，分析临床资料及疗效。其中单边外固定支架固定治疗(单边外固定支架组)51例，DHS内固定治疗(DHS组)57例，Gamma钉内固定治疗(Gamma钉组)90例，经门诊复诊及通讯方式随访。从骨折愈合、负重时间、并发症发生率、手术过程、平均住院时间及髋关节功能恢复情况(优良率)等方面对3种不同治疗方法进行比较评价，并作统计学分析。
结果：3组病例均获随访，随访时间8～51个月，平均36个月。骨折愈合时间比较，差异无统计学意义 (P>0.05);负重时间及并发症比较，差异有统计学意义(P<0.05).3种方法中，切口长度以DHS组最长，单边外固定支架组最短；手术时间DHS组最长，单边外固定支架组最短；出血量以DHS组最多，单边外固定支架组最少；引流量以DHS组最多，单边外固定支架组最少；Gamma钉组适中。平均住院时间3组比较差异无统计学意义(P>0.05).髋关节功能比较，Gamma钉组优于DHS组(P<0.05)和单边外固定支架组(P<0.01).
结论：Gamma钉治疗股骨粗隆间骨折，负重时间早，髋关节功能恢复好，并发症率低，是治疗粗隆间骨折的较好方法。 |
| [关键词]:粗隆间骨折 外固定器 外科手术 动力髋螺钉 Gamma钉 |
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| The comparison of three operation methods for treatment of femoral intertrochanteric fracture |
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Abstract:
Objective: To investigate the therapeutic effect on femoral intertrochanteric fracture for three kinds of treatment methods and make theoretical analysis to offer basis on choosing the proper treatment method in clinic.
Methods: We retrospectively reviewed the clinical and radiological records of 198 patients with femoral intertrochanteric fracture for three kinds of different treatment:unilateral external fixation apparatus(51cases),dynamic hip screw(57 cases),internal fixation of Gamma nail(90 cases) from January 2001 to October 2006. The union of fracture and weight loading time,the averages length of stay,the incidence of complications,the functional evaluation of hip joint(the rate of excellent and good results) were compared and the curative effects were analyzed in different methods.
Results: Al1 the patients were followed-up for 36 months in average(from 8 months to 51 months).The union of fracture time were no statistically significant among the three groups(P>0.05).The weight loading time and incidence of complications were statistical significance among the three groups(P<0.05). Among the three groups,the incision length, operation time,blood loss and drainage in dynamic hip screw group were more than other groups,the unilateral external fixation apparatus group were less,Gamma nail group were in moderate. According to the Sanders' hip functional standard score,there were significant difference between the Grmma nail group and the other two groups(compared with dynamic hip screw group,P<0.05;compared with unilateral external fixation apparatus group,P<0.01).
Conclusion: The internal fixation of Gamma nail is a good choice for treating femoral intertrochanteric fracture.The weight loading time is earlier,the recovery of hip joint function is better,the incidence of complications is less in Gamma nail group than other two groups. |
| KEYWORDS:Intertrochanteric fracture External fixators Surgical procedure,operative Dynamic hip screw Gamma nail |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 何升华,彭俊宇,赵祥.股骨粗隆间骨折3种不同手术方式的病例对照研究[J].中国骨伤,2009,22(1):6~9 |
| 英文格式: | HE Sheng-hua,PENG Jun-yu,ZHAO Xiang.The comparison of three operation methods for treatment of femoral intertrochanteric fracture[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(1):6~9 |
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