Méndez-Gil A, Fernández-Valencia Laborde J Á, Estrada-Masllorens J M, Plaza-García R, Ríos Martín M, Camacho Carrasco P, Prat Fabregat S, Riba Ferret J
Servicio de Cirugía Ortopédica y Traumatología, ICEMEQ, Hospital Clínic, Universidad de Barcelona, Barcelona, España.
Servicio de Cirugía Ortopédica y Traumatología, ICEMEQ, Hospital Clínic, Universidad de Barcelona, Barcelona, España.
Rev Esp Cir Ortop Traumatol. 2014 Nov-Dec;58(6):351-6. doi: 10.1016/j.recot.2014.03.005. Epub 2014 Jul 14.
The treatment of intertrochanteric fractures using a minimally invasive dynamic hip screw (MIDHS) technique has been reported to provide better results than the conventional technique (CDHS). The present study aims to determine whether there are any differences in terms of transfusion needs, morbidity, length of hospital stay, and economical costs, based on a study of two retrospective cohorts.
Cohorts study of 80 patients with intertrochanteric femoral fractures (31-A1 and 31-A2.1) who underwent DHS procedure from July 2005 to September 2007; 40 of them were treated using the traditional technique (CDHS), and the other 40 using the minimally invasive technique (MIDHS).
No differences were found in terms of blood loss, transfusion requirements or morbidity. Mean hospital stay for MIDHS group was 1.3 days lower, reducing the costs regarding the CDHS group by €306.3, but this difference was not statistically significant (P=.3). The time required to perform the surgery was shorter for the MIDHS group: 49.3 versus 78.8minutes (p=0.0001).
Contrary to previous studies published, the present study did not show any advantage for the MIDHS technique, except for a shorter surgical time to perform the procedure. We consider that the MIDHS could help in improving operating room productivity and efficiency.
据报道,采用微创动力髋螺钉(MIDHS)技术治疗股骨转子间骨折比传统技术(CDHS)效果更好。本研究旨在通过对两个回顾性队列的研究,确定在输血需求、发病率、住院时间和经济成本方面是否存在差异。
对2005年7月至2007年9月期间接受DHS手术的80例股骨转子间骨折(31 - A1和31 - A2.1)患者进行队列研究;其中40例采用传统技术(CDHS)治疗,另外40例采用微创技术(MIDHS)治疗。
在失血、输血需求或发病率方面未发现差异。MIDHS组的平均住院时间短1.3天,使费用比CDHS组减少306.3欧元,但这种差异无统计学意义(P = 0.3)。MIDHS组手术所需时间较短:49.3分钟对78.8分钟(p = 0.0001)。
与先前发表的研究相反,本研究未显示MIDHS技术有任何优势,除了手术操作时间较短。我们认为MIDHS有助于提高手术室的工作效率。