锁定加压接骨板与解剖型接骨板治疗股骨转子间骨折：107例比较

背景：对于股骨转子间骨折特别是老年股骨转子间骨折，由于其处于应力集中部位且为松质骨，寻求一种能坚强固定且创伤小的方式一直是骨科同仁努力探索的方向，近几年文献报道解剖钢板用于转子间骨折较多，但锁定加压接骨板鲜有报道。 目的：比较锁定加压钢板与解剖钢板治疗股骨转子间骨折疗效的差异。　 方法：2005-03/2008-06应用解剖钢板及锁定加压钢板治疗股骨转子间骨折107例，其中应用解剖钢板固定62例，应用锁定加压钢板治疗45例。解剖钢板为德国Link公司产品，材料为不锈钢；锁定加压钢板为中国威高骨科材料有限公司产品，材料为钛合金。比较两种钢板用于治疗股骨转子间骨折的手术参数及内固定后随访结果。 结果与结论：两组患者内固定后随访6个月~2年，平均13个月。解剖钢板组出现螺钉松动、退钉，髋内翻畸形愈合7例，不愈合2例，深静脉血栓形成2例，内固定后切口感染1例；锁定加压钢板组轻度髋内翻畸形愈合1例，深静脉血栓形成1例。锁定加压钢板组内固定后并发症发生率明显低于解剖钢板组(P < 0.05)，且锁定加压钢板组最终髋关节功能优良率明显高于解剖钢板组(P < 0.05)。由此可见应用锁定加压钢板治疗股骨转子间骨折，特别是对于老年骨质疏松患者，较解剖钢板治疗有固定更加确切可靠及并发症少的优点。

Locking compression plate versus anatomical plate for intertrochanteric fractures in 107 cases

BACKGROUND: The intertrochanteric fracture, in particular in the elderly, is the site of stress concentration. To seek a firm fixation and minimally invasive way has been the efforts by orthopedic associates. In recent years, anatomical plate has been reported to be used for intertrochanteric fractures, but the locking compression plate has been reported rarely. OBJECTIVE: To investigate the efficacy between locking compression plate (LCP) and anatomical plate for the treatment of intertrochanteric fracture. METHODS: From March 2005 to June 2008, 107 cases of intertrochanteric fracture of femur were treated with anatomical plate or LCP, including 62 cases with anatomical plate and 45 with LCP. Anatomical plate, stainless steel, was purchased from Link, Germany; LCP, titanium alloy, was purchased from Weigao Orthopedic Materials, China. The operation parameters and follow-up results following fixation using two methods were compared RESULTS AND CONCLUSION: The patients of two groups were followed up from 6 months to 2 years, with the average time of 13 months. In anatomical plate group, there were loose screws, nails back and coxa vara in 7 cases, nonunion in 2 cases, deep vein thrombosis in 2 cases and postoperative wound infection in 1 case. In LCP group, there were mild coxa vara and malunion in 1 case and deep venous thrombosis in 1 case. The incidence of postoperative complications in LCP group was significantly lower than anatomical plate group (P < 0.05), and the excellent and good rate of hip function was significantly better than in the anatomical plate group (P < 0.05). Compared with anatomical plate for the treatment of intertrochanteric fracture, especially in elderly patients with osteoporosis, LCP displayed reliable effect and higher rate of fracture healing but less complications.