Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
J Trauma Acute Care Surg. 2012 May;72(5):1435-43. doi: 10.1097/TA.0b013e318247252a.
Intertrochanteric hip fractures are associated with high morbidity and mortality rates. Percutaneous compression plating (PCCP) is a minimally invasive technique for fracture fixation that has been advocated to reduce blood loss, relieve pain, and lead to faster rehabilitation. The present systematic review and meta-analysis was performed to evaluate PCCP in patients with intertrochanteric hip fractures compared with patients with sliding hip screw (SHS).
A comprehensive review of related literature was conducted to identify all articles in PubMed, EMBASE, Springer, Ovid, China National Knowledge Infrastructure (CNKI), and the Cochrane Central Register of Controlled Trials published on or before July 26th, 2011. Only prospective or retrospective comparative studies reporting clinical and radiographic outcomes of PCCP for intertrochanteric hip fractures were included. The methodological qualities of the included studies were assessed using the Coleman methodology score, and the reported data of individual studies were extracted. Meta-analytic pooling of group outcomes across studies was performed for both the PCCP and SHS techniques.
Fourteen studies met the inclusion criteria. Minimally invasive PCCP was associated with a decrease in surgical time, blood loss, transfusion rate, and systematic complications. No significant differences between PCCP and SHS were observed in other parameters, including hospital stay, mortality, reoperation, implant-related complications.
Based on these finding, PCCP appeared similar to SHS in terms of mechanical stability in the clinical setting, but had obvious advantages in terms of blood loss, transfusion need, and systematic complications, which may be attributed to reduced soft tissue and bone damage. Although orthopedic surgeons are advised to consider PCCP fixation as an additional alternative treatment for intertrochanteric fractures, high-quality randomized trials are still needed to assess the benefits of this minimally invasive technique.
III, systematic review.
股骨转子间骨折与高发病率和死亡率相关。经皮加压钢板（PCCP）是一种微创技术，用于骨折固定，已被提倡以减少失血、缓解疼痛并导致更快的康复。本系统评价和荟萃分析旨在评估与滑动髋螺钉（SHS）相比，PCCP 在股骨转子间骨折患者中的作用。
对 PubMed、EMBASE、Springer、Ovid、中国知网（CNKI）和 Cochrane 对照试验中心注册库进行全面文献回顾，以确定 2011 年 7 月 26 日之前发表的所有有关 PCCP 治疗股骨转子间骨折的前瞻性或回顾性对照研究的文章。仅纳入报告了 PCCP 治疗股骨转子间骨折的临床和影像学结果的前瞻性或回顾性对照研究。使用 Coleman 方法评分评估纳入研究的方法学质量，并提取各研究的报告数据。对 PCCP 和 SHS 两种技术的组间结果进行荟萃分析。
14 项研究符合纳入标准。微创 PCCP 可减少手术时间、失血量、输血率和系统并发症。在其他参数方面，包括住院时间、死亡率、再次手术、植入物相关并发症，PCCP 与 SHS 之间无显著差异。
基于这些发现，PCCP 在临床环境中的机械稳定性方面与 SHS 相似，但在失血量、输血需求和系统并发症方面具有明显优势，这可能归因于软组织和骨损伤减少。尽管建议骨科医生将 PCCP 固定作为股骨转子间骨折的另一种治疗选择，但仍需要高质量的随机试验来评估这种微创技术的益处。
III，系统评价。
