摘要
目的：比较Gamma加长型与短型髓内钉治疗高龄股骨粗隆间骨折的疗效。方法回顾性分析2011年1月～2013年12月收治的56例高龄股骨粗隆间骨折（ Müller AO／OTA31－A1／A2）患者的临床资料，其中男性37例，女性19例，年龄65～88岁，平均（72．18±5．23）岁。其中使用Gamma短型髓内钉33例[男性21例，女性12例；平均年龄（73．21±6．24）岁]，Gamma加长型髓内钉23例[男性16例，女性7例；平均年龄（68．88±7．61）岁]。比较两组术中出血量、手术时间、术后血红蛋白、术日输血率、住院时间、术后1年Harris评分。结果加长型组出血量（149．11±87．31）mL，手术时间（73．80±17．40）min，术后1d血红蛋白（101．13±1．21） g／L，输血15例（65．2％），住院时间（14．12±0．23） d，术后1年 Harris 评分（90．20± 1．70）分。短型组出血量（93．25±61．26） mL，手术时间（53．30±15．70） min，术后1d血红蛋白（102．47±1．32）g／L，输血12例（36．4％），住院时间（13．38±0．97）d，术后1年Harris评分（88．90±2．31）分。两组术中出血量、手术时间、术日输血率比较差异有统计学意义（P＜0．05）；血红蛋白量、住院时间、术后1年Harris评分差异无统计学意义。结论加长型与短型髓内钉治疗AO／OTA31－A1型和31－A2型股骨粗隆间骨折在术后功能恢复上无差异，术后随访短型髓内钉更具有优势。
Abstract
Objective To compare the treatment of intertrochanteric fracture with Gamma long versus short intramedullary nails .Methods Fifty-six elderly patients with intertrochanteric fracture of femur ( AO/OTA31-A1;A2,37 males,19 females) were divided into short intramedullary nails group [including 21 males and 12 females with a mean age of (73.21 ±6.24) years] and long intramedullary nails group [ including 16 males and 7 females with a mean age of (68.88 ±7.61) years].Medical records were reviewed for age ,gender,estimated blood loss, operative time ,preoperative hemoglobin ,transfusion rate ,length of stay and Harris scores 1 year after the operation . Results The average estimated blood loss [(149.11 ±87.31)mL] and transfusion rate(65.2%) for long nails were found to be significantly greater (P<0.01) than the average estimated blood loss [(93.25 ±61.26 )mL] and transfusion rate(36.4%) for short nails.The average operative time was also found to be significantly greater (P<0.01) for long [(73.80 ±17.40) minutes] than for short [(53.30 ±15.70) minutes] intramedullary nail proce-dures.But there was no significant difference in preoperative hemoglobin ,length of stay and Harris scores 1 year af-ter the operation.Conclusion Short intramedullary nails were found to be better than long intramedullary nails for less operation wound .
NETL
NSTL
维普
万方数据