PCCP和DHS治疗老年股骨转子间骨折比较研究

Efficacy of PCCP and DHS in treatment of intertrochanteric hip fractures in elderly patients

目的比较经皮加压钢板（PCCP）和动力髋螺钉（DHS）内固定治疗老年股骨转子问骨折的临床效果。方法2008--2012年采用PCCP及DHS内固定治疗老年股骨转子间骨折患者93例，PCCP组44例，DHS组49例，观察手术时间、术中失血量、切口大小、术后伤口疼痛情况，术后随访观察骨折愈合情况及有无内固定失败、髋内翻畸形、股骨头切割等髋部并发症情况，术后1年评估髋关节功能恢复情况。结果所有患者随访12～21个月，平均15．5个月，平均手术时间、术中平均失血量、切口长度、术后48h疼痛VAS评分PCCP组均少于DHS组，差异具有统计学意义（P〈0．01）；术后半年2组所有患者骨折完全愈合，均未见内固定失败、髋内翻畸形、股骨头切割等髋部并发症；术后1年髋关节功能Harris评分2组差异无统计学意义（P〉0．05）。结论DHS和PCCP均是治疗老年股骨转子间骨折的可靠的内固定方法，PCCP具有创伤小、出血少、手术时间较短，术后疼痛轻的优点。

Objective To compare the clinical results of pereutaneous compression plating （PCCP） and Dynamic Hip Screw（DHS） in the treatment of intertrochanteric hip fractures in elderly patients. Methods From 2008 to 2012,93 eld- erly patients with intertrochanterie hip fractures were recruited and randomly divided into two groups. 44 patients were treated with PCCP and 49 patients with DHS. The operation time, blood loss,incision length, pain, healing of fracture, the complication and functional recovery were observed. Results All patients were followed for 12 - 21 months（ average 15.5 months）. The operation time, blood loss, length of incision, VAS scores in PCCP group were significantly less than those in DHS group, but there was no significant difference in Harris score between two groups one year later. All fractures in two groups were healed in six months after the operation without any complications such as failure of internal fixation, cut-outs and hip varus deformation. Conclusion PCCP and DHS are both ideal fixation methods for the treatment of intertrochan- teric hip fractures of elderly patients, but the PCCP showed minimal invasion, less blood loss, shorter operation time and less pain.