经皮微创加压钢板固定治疗股骨转子间骨折的临床研究

Clinical study on the curative effect of minimally invasive percutaneous compression plate on the intertrochanteric fracture

目的:观察经皮微创加压钢板固定治疗股骨转子间骨折的临床疗效。方法:将48例股骨转子间骨折患者随机分为2组,每组24例,切开复位后分别采用经皮微创加压钢板与股骨近端髓内钉-抗螺旋刀片进行内固定,观察2组患者手术时间、术中出血量、住院时间、临床疗效、并发症等方面的情况,并进行比较。结果:2组间手术时间、术中出血量、住院天数、随访时间、临床疗效的差异无统计学意义(t=1.149,P=0.263;t=1.167,P=0.256;t=1.459,P=0.159;t=0.675,P=0.503;Z=0.000,P=1.000)。经皮微创加压钢板内固定组术后并发髋内翻畸形2例,肢体短缩1例;股骨近端髓内钉-抗螺旋刀片内固定组术后并发肺栓塞1例,髋内翻畸形2例,步态改变1例,肢体短缩1例;所有发生并发症的患者均有不同程度的髋部疼痛。结论:经皮微创加压钢板内固定治疗股骨转子间骨折操作简单、创伤小、并发症少,是手术治疗股骨转子间骨折理想的内固定方法之一。

Objective：To observe the clinical curative effect of minimally invasive percutaneous compression plate（MIPCCP）on the intertrochanteric fracture.Methods：Forty-eight patients with intertrochanteric fracture were randomly divided into 2 groups,24 cases in each group.Patients were administrated with internal fixation by MIPCCP and proximal femoral nail anti-rotation（PFNA）after open reduction respectively according to different groups.Such parameters as operation time,amount of blood loss,length of stay in hospital,clinical curative effect and complications were observed and compared between the 2 groups.Results：There was no statistical difference between the 2 groups in the aspects of operation time,amount of blood loss,length of stay in hospital,clinical,follow-up time and curative effect（t=1.149,P=0.263;t=1.167,P=0.256;t=1.459,P=0.159;t=0.675,P=0.503;Z=0.000,P=1.000）.After the operation,2 cases with coxa vara deformity and 1 case with extremity shortness were found in group MIPCCP;1 case with pulmonary embolism,2 cases with coxa vara deformity,1 case with altered tread and 1 case with extremity shortness were found in group PFNA.All the patients with complications were accompanied with different degrees of hip pains.Conclusion：The method of internal fixation with MIPCCP has the advantages of simple operation,minimal-invasion and less complications,so it is one of the ideal internal fixation method in the operative treatment of intertrochanteric fracture.