DHS和Gamma钉内固定治疗股骨粗隆间骨折的临床对比研究
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摘要
目的:探讨应用DHS(dynamic hip screw)内固定与Gamma钉内固定治疗股骨粗隆间骨折(EvansⅢ)的临床疗效对比。
方法:全部病例均来自长春中医药大学附属医院和苏州市中医院骨伤科,自2010.2-2011.4根据病例纳入标准和排除标准,选择股骨粗隆间骨折60例,其中DHS内固定30例,Gamma钉内固定30例,通过对其性别、年龄、原发病情况、术后合并症及恢复情况、平均手术时间、手术切口、术中出血量、术后颈干角丢失度等进行对比分析,数据采用SPSS for windows13.0统计软件包进行统计分析。
结果:DHS内固定与Gamma钉内固定治疗股骨粗隆间骨折(EvansⅢ)有效率及髋内翻率经统计无显著性差异(P>0.05),优良率Gamma钉内固定和DHS内固定组相似,手术时间、术中出血量Gamma钉组少于DHS组。
结论:DHS与Gamma钉都是治疗股骨粗隆间骨折的理想材料,在控制创伤方面Gamma钉优于DHS。
Objective:to study the clinical curative effect of contrast of the dynamic hip screw application (DHS )internal fixation and Gamma nail internal fixation for intertrochanteric fractures (EvansⅢ).
Methods: All patients were from Orthopedics of Affiliated Hospital of Changchun University of Chinese Medicine and Suzhou Hospital of Traditional Chinese Medicine since 2010.2-2011.4 , according to case the inclusion criteria and exclusion standard, the choice of intertrochanteric fractures within 60 cases, including DHS 30 cases and Gamma nail fixed within 30 cases of fixed. We had comparative analysis by SPSS by the gender,age,the original incidence,postoperative complications and recovery and the mean operative time,incision on average,the amount of bleeding during surgery,and the lost degree of postoperative neck-shaft angle . the data was analysed by statistical software package of SPSS for windows13.0 .
Results:The effective rates and the incidence rates of hip joint valgus of dynamic hip screw(DHS)group and Gamma nail group had no distinct difference by treating statistically (P>0.05), Excellent rate of Gamma nail group and DHS group were similar ,Gamma nail group was less than DHS group in the timing of the operation and the amount of bleeding during surgery.
Conclusion : DHS and Gamma nails are the ideal materials to fixation of intertrochanteric fractures .Gamma nail is superior to DHS in terms of controlling operative trauma.
方法:全部病例均来自长春中医药大学附属医院和苏州市中医院骨伤科,自2010.2-2011.4根据病例纳入标准和排除标准,选择股骨粗隆间骨折60例,其中DHS内固定30例,Gamma钉内固定30例,通过对其性别、年龄、原发病情况、术后合并症及恢复情况、平均手术时间、手术切口、术中出血量、术后颈干角丢失度等进行对比分析,数据采用SPSS for windows13.0统计软件包进行统计分析。
结果:DHS内固定与Gamma钉内固定治疗股骨粗隆间骨折(EvansⅢ)有效率及髋内翻率经统计无显著性差异(P>0.05),优良率Gamma钉内固定和DHS内固定组相似,手术时间、术中出血量Gamma钉组少于DHS组。
结论:DHS与Gamma钉都是治疗股骨粗隆间骨折的理想材料,在控制创伤方面Gamma钉优于DHS。
Objective:to study the clinical curative effect of contrast of the dynamic hip screw application (DHS )internal fixation and Gamma nail internal fixation for intertrochanteric fractures (EvansⅢ).
Methods: All patients were from Orthopedics of Affiliated Hospital of Changchun University of Chinese Medicine and Suzhou Hospital of Traditional Chinese Medicine since 2010.2-2011.4 , according to case the inclusion criteria and exclusion standard, the choice of intertrochanteric fractures within 60 cases, including DHS 30 cases and Gamma nail fixed within 30 cases of fixed. We had comparative analysis by SPSS by the gender,age,the original incidence,postoperative complications and recovery and the mean operative time,incision on average,the amount of bleeding during surgery,and the lost degree of postoperative neck-shaft angle . the data was analysed by statistical software package of SPSS for windows13.0 .
Results:The effective rates and the incidence rates of hip joint valgus of dynamic hip screw(DHS)group and Gamma nail group had no distinct difference by treating statistically (P>0.05), Excellent rate of Gamma nail group and DHS group were similar ,Gamma nail group was less than DHS group in the timing of the operation and the amount of bleeding during surgery.
Conclusion : DHS and Gamma nails are the ideal materials to fixation of intertrochanteric fractures .Gamma nail is superior to DHS in terms of controlling operative trauma.
引文
[1]魏志宇,曲龙.三种老年股骨粗隆间骨折手术方式的疗效分析与选择对策[J].中国现代医药杂志,2010,7;12(7):71-72.
[2]何耀文,韩鹏飞.股骨粗隆间骨折的临床分型与治疗进展[J].中国药物与临床2010,8;10(8):904-905.
[3] S.TERRY CANALE[美]主编,卢世壁主译CAMPBELLS Operative Orthopaedics[M].济南:山东科学技术出版社,2001,9:2133-2170.
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[5]黄公怡.转子间骨折[J].中华骨科杂志,2003;23(10):637-640.
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[7] Lindskog DM,Baumgaertner MR.Unstableinter rochante richip fractures intheelderly.J Am Acad Orthop Surg,2004,12(3):179-190.
[8]蔡迎峰,陈胜,张维.股骨小粗隆缺损的生物力学评价及临床意义[J].骨与关节损伤杂志,2004,16(3):178-179.
[9] Lindskog DM,Baumgaertner MR.Unstableinter rochante richip fractures inthelderly,J Am Acad Orthop Surg,2004,12(3):178-179.
[10]刘钟华,杨世荣,回春.中药促进骨折愈合的实验研究概况[N].长春中医学院学报,2004,20(2):63.
[11]李钰鑫.应用DHS动力髋装置治疗股骨转子间骨折[J].中医正骨.2004,16(11):46-47.
[12]危杰.股骨转子间骨折[J].中华创伤骨科杂志,2004,6:554-557.
[13]赵文,李红芹.老年股骨转子间骨折的DHS治疗[J].中国现代医药杂志,2005,7(4):49-50.
[14]肖徳明.动力髋螺钉内固定治疗高龄股骨粗隆间骨折[J].中国矫形外科杂志,2005,13(2):98-100.
[15]谢松卿.Richard钉内固定治疗老年股骨粗隆间骨折手术并发症原因分析[J].中国矫形外科杂志,2005,13(12):906.
[16]田国杰.老年股骨粗隆间骨折非手术治疗72例[J] .中医药临床杂志, 2007;19(5):487-488.
[17]李俊,孟志斌,付坤.经皮穿针外固定治疗高龄股骨粗隆间骨折[N].海南大学学报, 2007;25(2).
[18]黄五京.交叉穿针外固定架固定治疗老年股骨粗隆间骨折[N].河南职工医学院学报,2008;20(5).
[19]刘震,杨永刚,李绍野.三针锁针加压器外固定治疗股骨粗隆间骨折4例[J].吉林中医药,2004;25(1):32-33.
[20]黄勇,林映湖.DHS内固定治疗股骨粗隆间骨折体会[J].浙江创伤外科.2008;13(2):110-111.
[21]彭小忠石展英.组合式外固定支架治疗高危老年股骨粗隆间骨折[J].Guangxi Medical Journal,Oct.2007,Vo1.29,No.10:1606~1607.
[22]陈福林.Gamma钉微创治疗股骨粗隆间骨折[J].当代医学,2009;15(22):177-178.
[23]陈希聪,熊昌盛,劳永锵,等.闭合复位PFNA内固定治疗股骨粗隆间骨折体会[N].赣南医学院学报,2009;29(1) :220-221.
[24]谢本武,汤多军,吴亚平,等.“8"字钢丝张力带加多针内固定治疗股骨粗隆间骨折[J].解剖与临床,2006;11(4) :276-277..
[25]张应岩.解剖钢板内固定治疗老年股骨粗隆间骨折28例[J].贵州医药,2009;33(9):818-819.
[26]陈强,张建明,葛新,等.80岁以上股骨粗隆间骨折患者的手术治疗[J].浙江创伤外科,2007;12(5):417-418.
[27]涂一凡.直视下DHS治疗股骨粗隆间骨折及粗隆下骨折手术体会[J].中国医药导报.医护论坛,2009;6(19):222-223.
[28]李双,王栋,张世民.尖顶距与股骨头内拉力螺钉切出的研究进展[J].中国矫形外科杂志,2007;15(19):1484-1491.
[29]何轶健,陈志洪,冯树雄,等.动力髋螺钉结合防旋螺钉治疗高龄股骨粗隆间骨折[J].实用医学杂志,2007;23(l2):1888-1889.
[30]罗远健,陈海,谢硕胜,等.股骨近端锁定异型接骨板治疗不稳定型粗隆间骨折[J].华夏医学,2009;5(22):857-858.
[31]李雪峰,姜为民,王璐,等.4种内固定方式治疗股骨转子间骨折疗效对比[J].临床骨科杂志,2009,Jun;12(3):302-304.
[32]崔易坤,宋晋刚,尹振宇,等.改良Gamma钉治疗股骨粗隆间骨折41例分析[J].中国误诊学杂志,2006,l2;6(23):4655~4656.
[33]杨文君.人工股骨头置换治疗高龄股骨粗隆间骨折体会[N].辽宁医学院学报,2009 ,6;30(3):243.
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[2]何耀文,韩鹏飞.股骨粗隆间骨折的临床分型与治疗进展[J].中国药物与临床2010,8;10(8):904-905.
[3] S.TERRY CANALE[美]主编,卢世壁主译CAMPBELLS Operative Orthopaedics[M].济南:山东科学技术出版社,2001,9:2133-2170.
[4]裴培生,杨秀玲.牵引治疗老年性股骨粗隆间骨折体会[J].中国厂矿医学,2003;16(2):134-135.
[5]黄公怡.转子间骨折[J].中华骨科杂志,2003;23(10):637-640.
[6] Nielsen KD,Dammen I.Late sympotoms after hip fracture with displacement of the lesser trochanter.A case report.Acta Orthop Scand,2003;74:500-501.
[7] Lindskog DM,Baumgaertner MR.Unstableinter rochante richip fractures intheelderly.J Am Acad Orthop Surg,2004,12(3):179-190.
[8]蔡迎峰,陈胜,张维.股骨小粗隆缺损的生物力学评价及临床意义[J].骨与关节损伤杂志,2004,16(3):178-179.
[9] Lindskog DM,Baumgaertner MR.Unstableinter rochante richip fractures inthelderly,J Am Acad Orthop Surg,2004,12(3):178-179.
[10]刘钟华,杨世荣,回春.中药促进骨折愈合的实验研究概况[N].长春中医学院学报,2004,20(2):63.
[11]李钰鑫.应用DHS动力髋装置治疗股骨转子间骨折[J].中医正骨.2004,16(11):46-47.
[12]危杰.股骨转子间骨折[J].中华创伤骨科杂志,2004,6:554-557.
[13]赵文,李红芹.老年股骨转子间骨折的DHS治疗[J].中国现代医药杂志,2005,7(4):49-50.
[14]肖徳明.动力髋螺钉内固定治疗高龄股骨粗隆间骨折[J].中国矫形外科杂志,2005,13(2):98-100.
[15]谢松卿.Richard钉内固定治疗老年股骨粗隆间骨折手术并发症原因分析[J].中国矫形外科杂志,2005,13(12):906.
[16]田国杰.老年股骨粗隆间骨折非手术治疗72例[J] .中医药临床杂志, 2007;19(5):487-488.
[17]李俊,孟志斌,付坤.经皮穿针外固定治疗高龄股骨粗隆间骨折[N].海南大学学报, 2007;25(2).
[18]黄五京.交叉穿针外固定架固定治疗老年股骨粗隆间骨折[N].河南职工医学院学报,2008;20(5).
[19]刘震,杨永刚,李绍野.三针锁针加压器外固定治疗股骨粗隆间骨折4例[J].吉林中医药,2004;25(1):32-33.
[20]黄勇,林映湖.DHS内固定治疗股骨粗隆间骨折体会[J].浙江创伤外科.2008;13(2):110-111.
[21]彭小忠石展英.组合式外固定支架治疗高危老年股骨粗隆间骨折[J].Guangxi Medical Journal,Oct.2007,Vo1.29,No.10:1606~1607.
[22]陈福林.Gamma钉微创治疗股骨粗隆间骨折[J].当代医学,2009;15(22):177-178.
[23]陈希聪,熊昌盛,劳永锵,等.闭合复位PFNA内固定治疗股骨粗隆间骨折体会[N].赣南医学院学报,2009;29(1) :220-221.
[24]谢本武,汤多军,吴亚平,等.“8"字钢丝张力带加多针内固定治疗股骨粗隆间骨折[J].解剖与临床,2006;11(4) :276-277..
[25]张应岩.解剖钢板内固定治疗老年股骨粗隆间骨折28例[J].贵州医药,2009;33(9):818-819.
[26]陈强,张建明,葛新,等.80岁以上股骨粗隆间骨折患者的手术治疗[J].浙江创伤外科,2007;12(5):417-418.
[27]涂一凡.直视下DHS治疗股骨粗隆间骨折及粗隆下骨折手术体会[J].中国医药导报.医护论坛,2009;6(19):222-223.
[28]李双,王栋,张世民.尖顶距与股骨头内拉力螺钉切出的研究进展[J].中国矫形外科杂志,2007;15(19):1484-1491.
[29]何轶健,陈志洪,冯树雄,等.动力髋螺钉结合防旋螺钉治疗高龄股骨粗隆间骨折[J].实用医学杂志,2007;23(l2):1888-1889.
[30]罗远健,陈海,谢硕胜,等.股骨近端锁定异型接骨板治疗不稳定型粗隆间骨折[J].华夏医学,2009;5(22):857-858.
[31]李雪峰,姜为民,王璐,等.4种内固定方式治疗股骨转子间骨折疗效对比[J].临床骨科杂志,2009,Jun;12(3):302-304.
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