Ｇａｍｍａ３Ｕ-Ｂｌａｄｅ系统与Ｇａｍｍａ３钉固定治疗老年不稳定型 股骨转子间骨折的近期疗效比较

Objective To compare the short-term therapeutic effects of Gamma 3 U-Blade system and Gamma 3 nails in the treatment of elderly patients with osteoporotic unstable intertrochanteric fracture. Methods The data of 70 elderly patients with osteoporotic unstable intertrochanteric fracture were retrospectively analyzed who had been admitted to the Department of Orthopedics, Wuhan Fourth Hospital from June 2018 to December 2020. They were divided into 2 groups according to their treatments. In the U-Blade group of 35 cases subjected to fixation with Gamma 3 U-Blade system, there were 14 males and 21 females with an age of (77. 7 ±4. 8) years; in the Gamma 3 nail group of 35 cases subjected to fixation with Gamma 3 nails, there were 14 males and 21 females with an age of (79. 3 ±5. 2) years. The 2 groups were compared in terms of operation time, intraoperative blood loss, apex distance, fracture union time, postoperative complications, timed up and go (TUG) at postoperative 2 weeks, 3 months and 6 months, and hip function at postoperative 9 months. Results There was no statistically significant difference in the preoperative general data between the 2 groups, showing comparability (P > 0. 05). There was no significant difference either in operation time, intraoperative blood loss or apex distance between the 2 groups (P > 0. 05). The fracture union time [(12. 0 ± 0. 2) weeks] and Harris hip score at postoperative 9 months [90 (90, 91)] in the U-Blade group were insignificantly different from those in the Gamma 3 nail group [(12. 0 ± 0. 3) weeks and 91 (89, 91)] (P > 0. 05). The rate of implant-related complications in the U-Blade group [0% (0/35)] was significantly lower than that in the Gamma 3 nail group [17. 1% (6/35)] and the TUGs at postoperative 2 weeks and 3 months [(80. 2 ±3. 6) s and 45 (43, 49) s] in the former were significantly shorter than those in the latter [(89. 3 ±4. 2) sand 56 (54, 59) s] (P<0. 05). Conclusion In the treatment of elderly patients with osteoporotic unstable intertrochanteric fracture, compared with traditional Gamma 3 nails, Gamma 3 U-Blade system can reduce implant-related complications and facilitate early recovery of walking ability.