【摘要】 目的探讨Gamma钉与DHS治疗股骨转子周围骨折所致并发症的原因。方法1997年4月～2002年12月应用Gamma钉与DHS治疗股骨转子周围骨折152例,出现各种并发症15例。其中Gamma钉组23例,男10例,女13例;Evans分型:Ⅰ型2例,Ⅱ型6例,Ⅲ型10例,Ⅳ型5例。DHS组129例,男57例,女72例;Evans分型:Ⅰ型18例,Ⅱ型27例,Ⅲ型53例,Ⅳ型31例。DHS组采用AO推荐的手术方法。Gamma钉组参照Grosse推荐的手术方法。结果136例获随访,DHS组出现髋内翻6例,拉力螺钉切出2例,会阴部压疮1例,拉力螺钉滑移1例,死亡1例。Gamma钉组出现髋内翻2例,拉力螺钉切出1例,股骨颈基底骨折1例。关节功能优良率分别为87.2%和89.3%。结论Gamma钉与DHS治疗股骨转子周围骨折均有良好的疗效,我们应根据骨骼的质量、骨折块几何形状、复位情况、内固定的设计、内固定的位置以及手术设备条件和医师熟练操作程度等选择不同固定方式,减少各种并发症的发生。更多还原

【Abstract】 Objective To analyze the complications which occur in the treatm en t of femoral peritrochanteric fractures by Gamma nail and DHS. Methods 152 patie nts with femoral peritrochanteric fractures, 15 of whom had complications, were treated from April 1997 to December 2002. 23 of them, 10 male and 13 female, wer e treated by Gamma nail. Their Evans types: 2 Type Ⅰ, 6 Type Ⅱ, 10 Type Ⅲ, an d 5 Type Ⅳ. 129 of them, 57 male and 72 female, were treated by DHS. Their Evan s types: 18 Type Ⅰ, 27 Type Ⅱ, 53 Type Ⅲ, 31 Type Ⅳ. AO method was adopted i n DHS Group, and Grosse method was adopted in Gamma nail Group. Results 136 pati ents were followed up. In DHS Group, 6 patients had hip varus, 2 patients tensio n screw protrusion, 1 patient perineum bedsore, 1 patient tension screw dislocat ion, and 1 patient died. In Gamma nail Group, 2 patient suffered hip varus, 1 pa tient tension screw protrusion, and 1 patient femoral net base fracture. The rat e of fine joint function was 87.2%and 89.3%respectively for the two groups. Co nclusions The methods of Gamma nail and DHS result in satisfactory functional re covery in treatment of femoral peritrochanteric fractures. In order to reduce th e complications, we should choose the proper fixation method according to bone q uality, shapes of the fragments, reduction, the design and position of the inter nal fixation, as well as the operation equipment.更多还原