PFNA联合MIPPO技术治疗外侧壁破裂型股骨粗隆间骨折

PFNA combined with MIPPO in the treatment of intertrochanteric fracture with fractured lateral wall

目的:观察加长型股骨近端带螺旋刀片髓内钉(PFNA)联合微创经皮钢板固定(MIPPO)与单纯PFNA固定治疗外侧壁破裂型股骨粗隆间骨折的疗效。方法:选取2018年4月至2019年10月我院收治的62例外侧破裂型股骨粗隆间骨折患者,据手术方法不同分为对照组(PFNA固定,32例)及观察组(PFNA联合MIPPO技术固定,30例)。对比两组手术时间、术中失血量、术后下床时间、骨折愈合时间、末次随访髋关节Harris评分及内固定失败率。结果:与对照组相比,观察组手术时间更长,术中失血量更多(P<0.05);但观察组术后下床时间、骨折愈合时间、末次随访髋关节Harris评分均优于对照组(P<0.05)。两组内固定失败率差异无统计学意义(P>0.05)。结论:PFNA联合MIPPO技术固定是治疗外侧壁破裂型股骨粗隆间骨折的有效方法。

Objective:To observe the curative effect of proximal femoral nail anti-rotation(PFNA) combined with minimally invasive percutaneous plate osteosynthesis(MIPPO) and simple PFNA fixation in the treatment of intertrochanteric fracture with fractured lateral wall.Methods:62 patients with intertrochanteric fracture with fractured lateral wall admitted to our hospital from April 2018 to October 2019 were divided into control group(PFNA fixation, 32 cases) and observation group(PFNA combined with MIPPO, 30 cases) according to different surgical methods. The operation time, intraoperative blood loss, postoperative time of getting out of bed, fracture healing time, Harris score of hip joint at the last follow-up and failure rate of internal fixation were compared between the two groups.Results:Compared with the control group, the observation group had longer operation time and more blood loss during operation(P<0.05). However, the postoperative time of getting out of bed, fracture healing time, and Harris score of hip joint in the observation group were better than those in the control group(P<0.05). There was no significant difference in the failure rate of internal fixation between the two groups(P>0.05).Conclusion:PFNA combined with MIPPO is an effective method for the treatment of intertrochanteric fracture with fractured lateral wall.