锁定加压钢板与动力髋螺钉治疗股骨粗隆部骨折比较

Comparison between locking compression plate and dynamic hip screw for the treatment of intertrochanteric femoral fracture

目的比较锁定加压钢板(LCP)与动力髋螺钉(DHS)治疗股骨粗隆部骨折优缺点,探讨内固定选择的策略。方法观察比较DHS组和LCP组的手术时间、失血量、术中X线暴露量、骨折愈合时间,观察术后功能评分、优良率、并发症及负重情况。结果LCP组的失血量、手术时间、接受X线量,与DHS组比较,差异均有统计学意义(t分别=3.12、2.45、3.46,P均<0.05);LCP组的优良率(100%)与DHS组(88.09%)比较,差异无统计学意义(χ2=3.22,P>0.05);随访结果显示LCP组髋内翻、下肢长短、内固定断裂等并发症发生率比DHS组低。结论两种侧方钢板固定系统治疗股骨粗隆部骨折均可获得良好的疗效,使用解剖型LCP能减少手术创伤,降低X线暴露量,手术操作简单,适应证广。

Objective To investigate the selective strategy of the internal fixation methods for the treatment of intertrochanteric femoral fracture by comparing locking compression plate with dynamic hip screw. Methods Fiftyseven cases of intertrochanteric femoral fractures were treated with dynamic hip screw or anatomical locking compression plate. Data were collected for statistical analysis as following： operation time, blood loss, fluoroscopy exposure, clinical healing time of fracture, observed post-operative restored function, complications and weight bearing circs. Results The differences of operation time, blood loss, fluoroscopy exposure between two groups were significant （t=-3.12, 2.45, 3.46, P〈0.05 ）. Function restoration evaluated by Sander＂ score in group DHS was 88.09% and 100% in group LCP （X^2=3.22,P〉0.05）. In contrast with DHS group, LCP group had lower incidence rate of complications. Conclusion Both two internal fixation methods can obtain good functions. Using anatomical LCP can reduce operation wound and the dose of fluoroscopy exposure. Its technology is simple and has wider indications.