经皮加压钢板微创治疗高龄股骨转子间骨折的早期疗效

摘要

Objective To investigate the early results of the minimally invasive treatment of percutaneous compression plate (PCCP) for intertrochanteric fractures of elderly patients. Methods 25 elderly patients with intertrochanteric fractures in our hospital were treated with PCCP from November 2009 to December 2010. All cases received closed reduction on the traction bed and implanted with PCCP by minimally invasive. The operation time, intraoperative blood loss, VAS scores and the average healing time were observed. Results The mean operation time of 25 patients in this study was (38.3+16.6) min (29-90 min) and the mean blood loss was (72.6±48.3) mL (20-100 mL). All patients were followed up for 6 to 14 months, (9.8±1.3) months in average. The VAS scores showed that, the preoperative VAS scores were (6.23±0.63) points, the scores of one week in post-operation were (3.62±0.68) points, the scores of 3 months in post-operation were (2.23±0.52) points and the scores of last follow-up were (1.06±0.37) points. All patients received healing at stage one, and the average healing time was (2.8±1.2) months (2.2-4.3 months). The postoperative function of 88% patients recovered to the activity status before operation. Conclusion The treatment of PCCP for intertrochanteric fractures has early pain relief, firm fixed, fewer complications and rigid fixation, which can be well used in the minimally invasive treatment of intertrochanteric fractures of type A, and A2 in elderly patients.%目的 探讨经皮加压钢板(percutaneous compression plate,PCCP)微创治疗高龄股骨转子间骨折的初期疗效.方法 2009年11月～2010年12月我院采用PCCP治疗高龄股骨转子间骨折25例,骨折均采用牵引床闭合复位,微创植入PCCP,并观察患者手术时间、术中出血量、VAS评分及平均愈合时间的情况.结果本组25例患者平均手术时间为(38.3±16.6)min(29～90 min),平均术中出血量为(72.6±48.3)mL(20～100 mL).所有患者均随访6～14个月,平均(9.8±1.3)个月.VAS评分结果,术前为(6.23±0.63)分,术后1周为(3.62±0.68)分,术后1个月为(2.23±0.52)分,末次随访为(1.06±0.37)分.所有患者均获得Ⅰ期愈合,平均愈合时间为(2.8±1.2)个月(2.2～4.3个月).88%的患者术后功能恢复到伤前水平.结论 PCCP治疗股骨转子间骨折疼痛缓解早,固定牢靠,并发症少,可满意地用于高龄患者A1和A2型转子间骨折的微创治疗.