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经皮加压钢板与短重建钉治疗股骨转子间骨折的比较。

Comparison of percutaneous compression plating and short reconstruction nail for treatment of intertrochanteric fracture.

机构信息

Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

出版信息

Orthop Surg. 2011 Feb;3(1):14-21. doi: 10.1111/j.1757-7861.2010.00117.x.

Abstract

OBJECTIVE

To compare percutaneous compression plating (PCCP) with Trigen short reconstruction nail (Trigen SRN) for the treatment of intertrochanteric hip fracture.

METHODS

Eighty-four patients with intertrochanteric hip fracture admitted to our hospital from January 2007 to June 2008 were included in this retrospective study. Thirty-six patients were treated with PCCP and 48 with Trigen SRN. Information regarding age, surgical time, blood loss, length of follow-up, mortality, fracture impaction, time to union, complications, Harris score and visual analog scale (VAS) were all recorded.

RESULTS

The mean follow-up time was 16.3 ± 3.2 months (13-19 months). The mean time to achieve radiological fracture healing was 3.6 ± 0.8 and 4.1 ± 1.0 months for the PCCP and Trigen SRN groups, respectively (P= 0.020); the mean Harris hip scores were 78.1 ± 4.8 and 74.1 ± 5.2 (P= 0.001); and the mean fracture impaction was 3.6 ± 2.3 and 3.3 ± 2.6 mm (P= 0.023). There were no statistical differences between the two groups in duration of surgery (P= 0.131) and blood loss (P= 0.268). The amount of nail in the inferior-central quadrants was greater in the PCCP group than in the Trigen SRN group.

CONCLUSION

PCCP achieves earlier pain release and better fracture reduction than Trigen SRN.

摘要

目的

比较经皮加压钢板(PCCP)与 Trigen 短重建钉(Trigen SRN)治疗股骨转子间骨折的效果。

方法

回顾性分析 2007 年 1 月至 2008 年 6 月我院收治的 84 例股骨转子间骨折患者的临床资料,其中 36 例行 PCCP 治疗,48 例行 Trigen SRN 治疗。记录两组患者的年龄、手术时间、术中出血量、随访时间、死亡率、骨折嵌插程度、愈合时间、并发症发生情况、Harris 评分及视觉模拟评分(VAS)。

结果

患者平均随访时间为 16.3±3.2 个月(13~19 个月)。PCCP 组患者的骨折愈合时间为 3.6±0.8 个月,Trigen SRN 组为 4.1±1.0 个月,两组比较差异有统计学意义(P=0.020);PCCP 组患者的 Harris 髋关节评分优于 Trigen SRN 组,分别为 78.1±4.8 分和 74.1±5.2 分,两组比较差异有统计学意义(P=0.001);两组患者的骨折嵌插程度分别为 3.6±2.3mm 和 3.3±2.6mm,PCCP 组优于 Trigen SRN 组,两组比较差异有统计学意义(P=0.023)。两组患者的手术时间及术中出血量比较差异均无统计学意义(P>0.05)。PCCP 组内固定物在中下象限的量多于 Trigen SRN 组。

结论

PCCP 治疗股骨转子间骨折较 Trigen SRN 可更早缓解疼痛,获得更好的骨折复位。

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