手法复位配合经皮解剖锁定钢板内固定治疗高龄股骨转子间骨折的有效性与安全性研究

Effectiveness and Safety of Manual Reduction Combined with Percutaneous Anatomical Locking Plate Fixation in Treating Elderly Intertrochanteric Fracture

目的:研究手法复位配合经皮解剖锁定钢板内固定治疗高龄股骨转子间骨折的有效性与安全性。方法:将2013年5月—2014年6月期间收治的高龄股骨转子间骨折患者120例纳入研究对象,采用随机数字表法分为观察组和对照组各60例,观察组患者接受手法复位配合经皮解剖锁定钢板内固定治疗,对照组患者接受切开复位配合髓内钉内固定治疗,比较两组患者的手术情况、骨折愈合情况关节功能以及并发症情况。结果:观察组术后引流量、术后卧床时间、影像学完全愈合时间、完全负重下地时间均明显低于对照组(17.82±3.6 VS 27.21±3.4,4.78±0.7 VS 7.25±1.1,104.42±15.42 VS 148.3±20.74,132.28±14.22 VS 189.23±21.44);术后6个月、1年Harris评分、Barthel指数均明显高于对照组(74.53±9.46 VS 60.52±7.15,80.35±11.52 VS 67.57±7.22;88.67±9.47 VS 76.34±8.36,91.78±11.32 VS 79.23±9.56);并发症明显低于对照组(3.00%VS 28.33%)。结论:手法复位配合经皮解剖锁定钢板内固定有助于减小手术创伤,促进骨折愈合,改善关节功能,提高治疗效果。

Objective：To study the effectiveness and safety of manual reduction combined with percutaneous anatomi cal locking plate fixation in treating elderly intertrochanteric fracture. Methods： 120 cases of elderly intertrochanteric fracture patients in our hospital from 2013.5 -2014.6 were randomly divided into observation group and control group.Observation group received manual reduction combined with percutaneous anatomic locking plate internal fixation and con- trol group received open reduction combined with intramedullary nail. And then operation condition ,fracture healing,joint function and complications were compared. Results ： Then observation group postoperative drainage volume, postoperative recovery time,radiographic healing time, full weight - bearing time were significantly lower than these of control group （ 17.82 ± 3.6 VS 27.21 ± 3.4,4.78±0.7VS7.25 ± 1.1,104.42 ±15.42VS 148.3 ±20.74,132.28 ± 14.22 VS 189. 23 ±21.44 ） , postoperative 6 months, 1 year, Harris score, Barthel index were significantly higher than those of control group（74.53 ±9.46 VS 60.52 ±7.15,80.35 ±11.52 VS 67.57 ±7.22; 88.67 ±9.47 VS 76.34 ±8.36,91.78±11. 32 VS 79.23±9.56）,complications rate was significantly lower than that of control group （3.00% VS 28.33% ）. Con- clusion：The manual reduction combined with percutaneous anatomical locking plate fixation is helpful to reduce operation trauma and promote healing, improving joint function, improve treatment effect.