股骨近端钢板内固定治疗股骨近端粉碎性骨折的临床疗效

Proximal Femoral Plate Fixation for Comminuted Fracture of Proximal Femur

目的探讨股骨近端钢板内固定治疗股骨近端粉碎性骨折的临床疗效。方法选择2014年5月至2015年5月解放军第八二医院骨科收治的48例行DHS手术治疗的老年股骨近端粉碎性骨折患者作为对照组,另选取同期收治的48例行股骨近端钢板内固定治疗的患者作为观察组。对比两组手术时间、术中出血量、术中引流量、骨折愈合时间、住院时间、Harris髋关节评分及不良反应发生情况。结果观察组手术时间、术中出血量、引流量、骨折愈合时间以及住院时间均少于对照组[(66±16)min比(90±20)min,(290±61)m L比(390±56)m L,(129±28)m L比(183±22)m L,(15±3)周比(22±3)周,(13±4)d比(19±7)d](P<0.01)。观察组治疗后Harris髋关节评分优良率为93.75%(45/48),高于对照组的72.92%(35/48)(P<0.05)。观察组不良反应发生率为6.25%(3/48),低于对照组的27.08%(13/48)(P<0.05)。结论对股骨近端粉碎性骨折患者给予股骨近端钢板内固定治疗可有效提高治疗效果,改善患者髋关节功能,提高手术治疗的安全性。

Objective To study the clinical efficacy of femoral proximal plate fixation in the treatment of comminuted proximal femoral fractures. Methods 48 elderly patients receiving DHS surgical treatment of proximal femoral comminuted fracture in Chinese PLA 82nd Hospital from May 2014 to May 2015 were as a control group,and 48 elderly patients with proximal femoral comminuted fracture treated with proximal femoral plate fixation during the same period as an observation group. The operation time,intraoperative blood loss,intraoperative drainage, fracture healing time, hospitalization time, Harris hip score and adverse reactions were compared between the two groups. Results The operation time, intraoperative blood loss ,drainage volume,fracture healing time and hospitalization time in the observation group were less than those in the control group[ （66 ± 16） min vs （90±20） min, （290±61） mL vs （390 ±56） mL, （129±28） mL vs （183 ±22） mL, （ 15 ± 3 ） weeks vs （22 ± 3 ） weeks, （ 13 ± 4） d vs （ 19 ±7 ） d ] （ P 〈 0. 01 ）. The excellent and good rate of Harris hip joint score was 93.75% （45/48） in the observation group,which was higher than that in the control group[72. 92% （35/48） ] （P 〈0. 05）. The incidence of adverse reactions was 6. 25% （3/48） in the observation group,which was lower than that in the in the control group 27.08% （ 13/48 ） （ P 〈 0. 05 ）. Conclusion For patients with femoral proximal comminuted frac- ture,proximal femur steel plate internal fixation treatment can effectively improve the therapeutic effect,improve the hip function, and improve the surgery safety.