经皮微创加压钢板治疗股骨转子间骨折的临床研究

Percutaneous compression plating for treatment of intertrochanteric fracture of femur

目的探讨经皮微创加压钢板(PCCP)用于治疗股骨转子间骨折的方法和疗效。方法 2011年5月至2011年12月,应用经皮加压钢板行内固定治疗股骨转子间骨折26例,对手术时间、受辐射的时间、失血量、手术切口、骨性愈合时间、术后并发症、髋关节功能等指标进行评估。结果手术时间48～120min,平均68min;术中C臂X线机透视平均使用时间为105s(90～140s);术中失血40～80ml,平均60ml;骨折骨性愈合时间11～13个月,平均12.2个月;术后1例因心肌梗塞死亡,其余25例恢复良好,无手术相关并发症;髋关节功能根据积水潭医院的疗效标准优良率达92%。结论应用PCCP钢板经皮微创内固定手术治疗股骨转子间骨折具有操作方便、创伤小、手术时间短、术中出血少、术中X线曝光时间短、愈合快及并发症少等优点,是治疗股骨转子间骨折的一种可靠方法。

Objective To evaluate the method and clinical results of percutaneous compression plating （PCCP） for intertrochanteric fracture of the femur. Methods During May to December 2011, 26 patients suffered intertrochanteric fracture of the femur were treated with PCCP. Analysis and comparison were performed on following indexes： operation duration, operative X-ray exposure time, bone healing time, incision size, hip function and operative complications, etc. Results The operation time was 48 - 120minutes（ average, 68 minutes） and the blood loss was 40 -80 ml （average, 60 ml） ; the C arm X-ray machine had worked 90 - 140 seconds （average, 105 seconds）. Except one died of heart attack, 25 eases achieved clinical bone healing by time about 12. 2 months in average without any complications. Conclusions The PCCP has many advantages such as less blood loss, less operation duration, less operative X-ray exposure time, simpler operation method, fewer complications and satisfactory effect. It can be successfully used as a minimal invasive technique to treat intertroehanteric fracture of the femur.