微创钉板系统治疗老年股骨粗隆间骨折的临床观察  

Clinical observation of femoral intertrochanteric fractures treated with the minimally invasive screw plate system in the elderly

作　　者：华祥[1] 沈岳[1] 宗兆文[1] 赵玉峰[1] 唐颖[1] 陈辉[1] 郭庆山[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所全军战创伤中心创伤外科,重庆400042

出　　处：《创伤外科杂志》2016年第2期72-74,共3页Journal of Traumatic Surgery

基　　金：国家科技支撑计划(2012BAI11B01);国家科技惠民计划(2013GS500101)

摘　　要：目的 观察微创钉板系统治疗老年股骨粗隆间骨折的临床效果。方法回顾分析2008年1月～2013年10月收治的61例老年股骨粗隆间骨折患者，男性15例，女性46例；年龄63—98岁，平均73．3岁。骨折按照AO分型：31—A1型19例和31-A2型42例。合并内科疾病61例。19例采用经皮加压钢板（PCCP组）固定，42例采用小切口动力髋螺钉（DHS组）固定，术后常规护理并行早期康复训练，观察两组患者手术时间、术中出血量及并发症率。结果PCCP组和DHS组手术时间平均为45．5min和60rain，术中出血PCCP组100—150mL，DHS组150—300mL。无严重并发症发生。61例患者均得到随访，时间12—24个月，平均17个月。术后x线片评估均达到或接近解剖复位，术后3个月骨痂生长良好，未出现内置物异常等并发症。根据Harris评分，髋关节功能优良。结论PCCP是治疗老年股骨粗隆问骨折的理想固定方式之一，而在无法实施PCCP治疗时，小切口置入DHS仍是良好的选择。Objective To evaluate the clinical effect of minimally invasive internal fixation in the treatment of femoral intertrochanteric fractures in elderly patients. Methods Sixty one elderly patients from Jan. 2008 to Oct. 2013 were included in the study,including 15 males and 46 females with an average age of 73.3（63-98） years. According to AO classification,19 were Type 31-A1 and 42 were 31-A2. All cases were associated with medical disea- ses. Ninteen cases were treated with PCCP,42 cases with DHS through small incision. Routine nursing and early recovery exercise were carried out. Results The average surgical time for PCCP and DHS was 45 minutes and 60 mi- nutes,respectively,and the perioperative blood loss ranged from 100mL to 150mL in the PCCP group and 150mL to 300mL in the DHS group. No severe complications were recorded. X-ray radiograph showed that anatomic or near anatomic reduction of the fracture was achieved. The functional recovery was excellent or good. Conclusion Using percutaneous compression plating in the treatment of elderly intertrochanterie fractures is an ideal method of fixation. While PCCP is impracticable,the percutaneous fixation with DHS is still a good choice.

关 键 词：股骨粗隆间骨折 螺钉 钢板 微创 

分 类 号：R683.42[医药卫生—骨科学]