Gaddi Diego, Piarulli Giorgio, Angeloni Andrea, Gandolla Marta, Munegato Daniele, Bigoni Marco
Clinica Ortopedica AO San Gerardo, Università degli Studi di Milano-Bicocca, Via Pergolesi 33, 20900, Monza, Italy,
Aging Clin Exp Res. 2014 Oct;26(5):497-503. doi: 10.1007/s40520-014-0205-3. Epub 2014 Mar 17.
Intertrochanteric fractures are among the most common fracture in elderly and are correlated with an average 1-year mortality of 25 %. Increased mortality after hip fracture could be related to blood loss and comorbidities.
We compared two groups of patients treated with percutaneous compression plating (PCCP) and dynamic hip screw (DHS) with the hypothesis that treatment with PCCP can reduce blood loss and 1-year mortality. We furthermore investigated the role of several surgical-related and patient-related factors on mortality of all the enrolled patients.
We performed a comparative retrospective study of 280 patients with type 31A1 or 31A2 hip fractures treated in our department from January 2004 to May 2008. Exclusion criteria were age <60 years, multiple injuries and pathological fractures. A total of 194 patients were treated with DHS, and 86 patients were treated with PCCP.
No statistical differences were found in term of blood loss, blood transfusion and 1-year mortality between the two groups, whereas we found a significant incidence of gender, age, American Society of Anaesthesiologists score and preoperative haemoglobin on mortality.
Both plates seem to be comparable in terms of blood loss and blood transfusion rate, and mortality was rather correlated with some patient-related factors reflecting the global health status.
Emerging mortality in this kind of patient should encourage us to improve preventative orthogeriatric health care.
转子间骨折是老年人最常见的骨折之一，平均1年死亡率为25%。髋部骨折后死亡率增加可能与失血和合并症有关。
我们比较了两组接受经皮加压钢板（PCCP）和动力髋螺钉（DHS）治疗的患者，假设PCCP治疗可减少失血和1年死亡率。我们还研究了几种手术相关和患者相关因素对所有入选患者死亡率的影响。
我们对2004年1月至2008年5月在我科治疗的280例31A1型或31A2型髋部骨折患者进行了一项比较性回顾性研究。排除标准为年龄<60岁、多发伤和病理性骨折。194例患者接受了DHS治疗，86例患者接受了PCCP治疗。
两组在失血、输血和1年死亡率方面未发现统计学差异，而我们发现性别、年龄、美国麻醉医师协会评分和术前血红蛋白对死亡率有显著影响。
两种钢板在失血和输血率方面似乎相当，死亡率与一些反映整体健康状况的患者相关因素密切相关。
这类患者中不断出现的死亡率应促使我们改善预防性老年骨科医疗保健。
