锁定钛板结合微创经皮钢板内固定技术治疗股骨粗隆间骨折的临床疗效观察

Clinical efficacy of locking titanium plate combined with minimally invasive percutaneous plate osteosynthesis technology in the treatment of intertrochanteric fracture

目的 探讨锁定钛板结合微创经皮钢板内固定（MIPPO）技术治疗股骨粗隆间骨折的手术方法及临床疗效.方法 采用股骨粗隆锁定钛板结合MIPPO技术治疗股骨粗隆间骨折21例.其中男8例,女13例;年龄61-82岁,平均72.1岁.按Evans-Jensen标准分型并根据改良Harris标准进行疗效评定.结果随访时间为12-35个月（平均22.5个月）,其中1例术后2个月因急性心肌梗死死亡,其余20例均获骨性愈合.末次随访时Harris评分88.35分（63-95分）,其中优14例,良4例,尚可1,差1例,优良率90％.结论锁定钛板应用MIPPO技术治疗股骨粗隆间骨折具有微创、固定可靠、骨折愈合率高等优点,允许早期髋关节不负重条件下功能锻炼,从而获得理想治疗效果.

Objective To explore the clinical curative effect of locking titanium plate combined with mini-mally invasive percutaneous plate osteosynthesis （ MIPPO） technology in the treatment of intertrochanteric fracture . Methods 21 patients with intertrochanteric fracture were treated with locking titanium plate combined with MIPPO technology.Male in 8 cases,female in 13 cases,age was 61 -82 years old,average 72.1 years.They were typed according to the Evans standard and the curative effects were evaluated according to the improved Harris standard . Results The follow-up time was 12-35 months （average 22.5 months）,after two months,one case died because of acute myocardial infarction ,the other patients were bony healing .The Harris scoring was 88.35 points at the time of the last follow-up（63 -95 points）,including excellent in 14 cases,good in 4 cases,fair in 1 case and poor in 1 case,the excellent rate was 90%.Conclusion Locking titanium plate combined with MIPPO technology in the treatment of intertrochanteric fracture has advantage of minimal invasion ,reliable fixation,high rate of fracture heal-ing,it allows early hip joint exercise without weight to achieve an ideal treatment effect .