经皮加压钢板治疗老年患者股骨逆粗隆间骨折17例临床观察

目的 评价经皮加压钢板(percutaneous compression plate,PCCP)治疗股骨逆粗隆间骨折患者的临床疗效.方法 选取2014年10月至2016年10月第三军医大学附属西南医院骨科采用PCCP治疗的股骨逆粗隆间骨折患者17例,回顾性分析其临床治疗效果.结果 1例患者术后25 d死于肺部感染,16例患者获得12个月随访;发生髋内翻患者2例,活动后出现轻度疼痛;2例患者发生骨折塌陷,活动后出现重度疼痛.所有患者都获得骨性愈合,均未再次手术,末次随访Harris评分为(84.1±9.7)分.疼痛并发症发生的预测因素显示,复位不良的患者更容易并发疼痛症(P＜0.01),并有发生骨折塌陷的趋势(P＜0.05).结论 PCCP是一种可选择的治疗股骨逆粗隆间骨折的手术方法,其良好的骨折复位和理想的颈部螺钉位置是手术成功的关键.

Clinical observation on the effect of percutaneous compression plate in the treatment of 17 senile patients with reverse oblique intertrochanteric femoral fracture

Objective To evaluate the clinical effect of percutaneous compression plate (PCCP) in the treatment of 17 senile patients with reverse oblique AO/OTA 31-A3 intertrochanteric femoral fracture.Methods Seventeen patients with intertrochanteric femoral fracture treated with PCCP in the Department of Orthopaedics,Southwest Hospital Affiliated to Third Military Medical University,from October 2014 to October 2016 were chosen as research subjects.Retrospective analysis was made on the clinical effects of the treatment.Results One patient died of pulmonary infection 25 days after surgery,16 patients had medical follow-ups for 12 months,and 2 patients had malunion and there was mild pain following physical activity.Fracture collapse occurred in 2 patients,and there was severe pain following physical activity.All the patients had bony union,all without secondary surgery.The last follow-up indicated that mean Harris hip scores were (84.1 ±-9.7).The predicting factor for the occurrence of pain complications showed that patients with poor reduction were more likely to have pain complications (P ＜ 0.01),and with a trend of fracture collapse (P ＜ 0.05).Conclusion Percutaneous compression plate was an alternative for the treatment of AO/OTA 31-A3 intertrochanteric femoral fractures,but good fracture reduction and ideal placement position of the neck screw were the key to the success of surgery.