Guo Qingshan, Shen Yue, Zong Zhaowen, Zhao Yufeng, Liu Huayu, Hua Xiang, Chen Hui
Trauma Center, Institute of Surgery Research, Daping Hospital, Third Military Medical University, No. 10 Yangtze River Road, Yuzhong District, Chongqing, 400042, People's Republic of China.
J Orthop Sci. 2013 Nov;18(6):977-86. doi: 10.1007/s00776-013-0468-0. Epub 2013 Oct 2.
The treatment and management of hip fracture poses a great challenge for clinicians in osteology and surgery. The aim of this study is to compare the clinical effectiveness of the percutaneous compression plate (PCCP) versus proximal femoral nail anti-rotation (PFNA) in the treatment of intertrochanteric fractures in elderly patients.
A prospective randomized study was carried out from January 2008 to October 2011 involving 90 elderly patients with intertrochanteric fractures (90 hips) who underwent minimally invasive surgery using the PCCP or PFNA. Evaluation variables, including operation time, intra- and perioperative blood loss, duration of hospital stay, incidence of postoperative complications, and final clinical outcomes by the end of follow-up, were used to compare the benefits of these two implants.
Among 90 subjects, 45 received PCCPs and 45 received PFNAs. The baseline characteristics of the two groups were comparable. The median follow-up time was 16.9 months (12-24 months). In the PCCP group, the mean operative time was 53 min (40-75 min), and the mean intra- and perioperative blood losses were 100.7 ml (60-150 ml) and 916 ml (433-1339 ml), respectively, which were significantly lower than those in the PFNA group. Nevertheless, there was no statistical difference in the incidence of postoperative complications and final clinical outcomes including pain complaints, range of motion of the hip, postoperative hip function at 12 months, and the recovery of walking ability to pre-injury status between these two implants.
Overall, the PCCP and PFNA appear to have similar clinical effects in treating elderly patients with intertrochanteric fractures, although the PCCP provided shorter operation times and less blood loss than PFNA. Both implants discussed were demonstrated to be ideal for the treatment of femoral intertrochanteric fractures in elderly patients.
髋部骨折的治疗与管理对骨科和外科医生而言是一项巨大挑战。本研究旨在比较经皮加压钢板（PCCP）与股骨近端抗旋髓内钉（PFNA）治疗老年患者股骨转子间骨折的临床疗效。
2008年1月至2011年10月进行了一项前瞻性随机研究，纳入90例接受PCCP或PFNA微创手术的老年股骨转子间骨折患者（90髋）。采用包括手术时间、术中和围手术期失血量、住院时间、术后并发症发生率以及随访结束时的最终临床结局等评估变量，比较这两种植入物的优势。
90例受试者中，45例接受PCCP，45例接受PFNA。两组的基线特征具有可比性。中位随访时间为16.9个月（12 - 24个月）。PCCP组的平均手术时间为53分钟（40 - 75分钟），术中和围手术期平均失血量分别为100.7毫升（60 - 150毫升）和916毫升（433 - 1339毫升），均显著低于PFNA组。然而，这两种植入物在术后并发症发生率以及包括疼痛主诉、髋关节活动范围、术后12个月髋关节功能和步行能力恢复至伤前状态等最终临床结局方面无统计学差异。
总体而言，PCCP和PFNA在治疗老年股骨转子间骨折方面似乎具有相似的临床效果，尽管PCCP的手术时间比PFNA短，失血量也更少。所讨论的两种植入物均被证明是治疗老年患者股骨转子间骨折的理想选择。
