经皮加压钢板与动力髋螺钉手术治疗老年股骨粗隆间骨折疗效比较

Comparison of PCCP and DHS for treating femoral intertrochanteric fractures in elderly patients

目的探讨经皮加压钢板(PCCP)与动力髋螺钉(DHS)两种手术方式治疗老年股骨粗隆间骨折的围手术期反应、疗效,便于在老年股骨粗隆间骨折治疗中选择创伤小、疗效好的手术方式。方法收集我院2009年1月～2010年12月收治的年龄>60岁并进行PCCP或DHS手术治疗的股骨粗隆间骨折67例,对比分析PCCP和DHS两种术式治疗的相关情况。结果 67例中,PCCP手术30例,DHS手术37例,术后随访6～30个月,两组患者的年龄、性别、合并疾病、致伤原因、诊断分型、手术时间、术后输血量、血红蛋白与白蛋白下降程度对比无显著性差异,PCCP组切口长度明显短于DHS组;术中失血量、输血量明显较DHS组少;PCCP组住院天数、术后下床时间早晚、治疗结果也明显优于DHS组。结论 PCCP较DHS的手术创伤减少,是更好的治疗老年股骨粗隆间骨折的手术方式。

Objective There is a common perception that both percutaneous compression plate（PCCP） and dynamic hip screw（DHS） are accepted treatments of senile intertrochanteric fracture of femur.The purpose of this study was to analyze and compare the perioperative evaluations and outcomes after PCCP and DHS fixation,so as to find a minimally invasive treatment.Methods In this retrospective study,we evaluated 67 cases of senile（60 years） intertrochanteric fracture of femur treated with PCCP or DHS in our department from Jan.2009 to Dec.2010.The patients were divided into two groups,according to the devices（PCCP or DHS）.A biochemical comparison of serum markers was performed.The serum markers examined were hemoglobin（Hb） and albumen（Alb）.Results Of the 67 cases,30 cases were treated by PCCP,and 37 cases were treated by DHS.All 67 patients had an intertrochanteric fracture of femur,with similar vulnerant mechanism.No differences were observed with respect to operation time,complication,and the amount of postoperative blood transfusion.In terms of serum markers,both methods showed similar patterns of change for Hb and Alb.The patients treated by PCCP showed a significant decrease in intraoperative blood transfusion,intraoperative blood loss.PCCP group also demonstrated shorter incision length,better post recovery and therapeutic outcomes.Conclusion These findings suggest that PCCP fixation of intertrochanteric femoral fracture produces less operative damage,which is more suitable for treating femoral intertrochanteric fractures in elderly patients.