髓内固定和倒置微创锁定接骨板治疗老年性股骨近端转子部骨折疗效比较

Effect comparison of intramedullary fixation and inversion of minimally invasive locking plate treatment of the elderly patients with proximal femur rotor fracture

目的比较髓内钉固定和髓外倒置微创锁定接骨板治疗老年性股骨近端转子部骨折的疗效并评价其安全性。方法收集2009年2月至2013年11月我院收治的84例老年性股骨近端转子部骨折患者临床资料,按照内固定置入方式分为髓内固定组(髓内钉固定)和髓外固定组(髓外倒置微创锁定接骨板)各42例。比较两组手术时间、术中出血量、下地活动时间、住院时间、髋关节功能等指标。术后随访3年,比较两组远期并发症发生率。结果髓内固定组手术时间和总住院时间均明显低于髓外固定组(P<0.05);两组平均术中出血量、平均下地活动时间以及髋关节功能评分比较,差异均无统计学意义(均P>0.05);髓内固定组远期并发症发生率明显低于髓外固定组(P<0.05)。结论两种手术治疗老年性股骨近端转子部骨折疗效相当。由于倒置微创锁定接骨板的远期并发症较高,髓内固定仍是老年性股骨近端转子部骨折的首选手术方法。

Objective To compare the effect of intramedullary fixation and inversion of minimally invasive locking plate treatment of the elderly patients with proximal femur rotor fracture.Methods A total of 84 cases of the elderly patients with proximal femur rotor fracture in our hospital from February 2009 to November 2013 were collected and divided into intramedullary fixation group（intramedullary nail fixation）and external fixation group（inversion of minimally invasive locking plate）,with 42 cases in each group.The operation time,intraoperative blood loss,down time,length of hospital stay,hip function parameters and the long-term complications were compared.Results The operation time and length of hospital stay in intramedullary fixation group were lower than the external fixation group（P〈0.05）.The intraoperative blood loss,down time,hip function parameters had no significant difference（P〉0.05）in the two group.The long-term complications in external fixation group was obviously higher than intramedullary fixation group（P〈0.05）.Conclusion The curative effect of intramedullary fixation and inversion of minimally invasive locking plate treatment of the elderly patients with proximal femur rotor fracture are satisfactory.Due to the higher long-term complications of inversion of minimally invasive locking plate,the intramedullary fixation is the first choice for proximal femur rotor fracture.