经皮加压钢板治疗股骨粗隆间骨折

目的:探讨经皮加压钢板(percutaneous compression plate,PCCP)在治疗股骨粗隆间骨折的临床疗效。方法:自2008年9月至2009年3月应用PCCP治疗股骨粗隆间骨折24例,其中男13例,女11例。致伤原因:交通伤8例,摔伤12例,高处坠落伤4例。骨折按照Evans分型:I型6例,Ⅱ型10例,Ⅲ型4例,Ⅳ型4例;我们通过记录手术时间、术中出血量、术后并发症、骨折愈合情况和术后髋关节功能Harris评分来评价临床疗效。结果:手术时间55～85min,平均65min;出血量50～160ml,平均85ml。所有病例均获得5～11个月随访,平均随访9.3个月。所有患者骨折均愈合,骨折愈合时间2～5个月,平均9.5W。无髋内翻、股骨头切割、旋转移位、感染、内固定断裂、松动等并发症发生。患髋Harris评分70～97分,平均84分。结论:PCCP治疗股骨粗隆间骨折具有生物力学更合理、操作简便、创伤小、恢复快、固定有效牢靠、骨折愈合率高、并发症少的特点,尤其适用于伴有骨质疏松的老年患者。

Percutaneous compression plate in treatment of intertrochanteric fractures

Objective： To evaluate the clinical outcomes of percutaneous compression plate （PCCP）in treatment of intertrochanteric fractures. Methods：Twenty-four patients were treated with PCCP from September 2008 to March 2009. There were 13 men and 11 women ,the average age is 69.7 years old（from 32 to 94 years old）. Fractures were caused by traffic accident in 8 cases,falling down in 12 cases and falling from height in 4 cases. According to Evans classification, there were 6 cases of type I , 10 cases of type H ,4 cases of type HI ,4 cases of type IV. Operation time,blood loss,postoperative complications,fracture healing and postoperative hip function score were used to evaluate the clinical outcomes. Resuhs：The mean operation time was 65min and blood loss was 85ml. All the patients were followed up for 5-11 months, the mean period was 9.3 months. Fracture healing were achieved in all patients, with average healing time of 9.5 weeks （2-5months）. There were no wound infection , Coxa varus,cut-out, rotatlon,internal fixation loosening and other complications, The Hmris score of the hip was 70~97 points （average 84 points） in the last followed up.Conclusion：As a new technique, PCCP has advantages of simple operation,minimal invasive,quicker recovery,rigid fixation,fewer complications and high rate of fracture healing. It is suitzble for elderly patients with osteoporosis especially.