Liu Kang, Sun Long-Tai, Deng Xian-Hui, Wang Zi-Jun, Shi Xiao-Lin, Wu Lian-Guo, Liang Bo-Cheng
Department of Orthopaedics, the Second Affiliated Hospital, Zhejiang Chinese Medicine University, Hangzhaou 310005, Zhejiang, China.
Department of Orthopaedics, the Second Affiliated Hospital, Zhejiang Chinese Medicine University, Hangzhaou 310005, Zhejiang, China;
Zhongguo Gu Shang. 2016 Aug 25;29(8):689-692. doi: 10.3969/j.issn.1003-0034.2016.08.003.
To investigate the effects of proximal femoral locking plate (PFP) in treating osteoporotic intertrochanteric fractures and to analyze the failure cases.
Totally 32 patients with osteoporotic intertrochanteric fractures of Evans I and II were treated with improved locking PFP, including 17 males and 15 females with an average age of 77.3 years old ranging from 70 to 86 years old. After operation, according to Harris hip scores, the hip function and therapeutic effects were evaluated.
The observed 32 patients' operative time was (60.5±15.7) min, intraoperative blood loss was (128.8±73.6) ml;perioperative blood transfusion was (224.0±72.7) ml. Hospitalization time was from 14 to 20 d with an average of 17.2 d. All patients were followed up from 6 to 18 months with an average of 14.1 months. The fracture healing time was from 3 to 6 months with an average of 3.1 months. One patient occurred internal fixation loosening and screw backward, 4 cases occurred urinary tract infection, 1 patient died of cardiovascular disease for 6 months postoperative, 2 patients died of a stroke for 1 year postoperative. No incision deep infection, peri internal fixation fractures, lower extremity deep venous thrombosis, internal fixation breakage, nonunion, severe coax vara and coax valgus occurred. The final Harris score was 89.74±6.84, the result was excellent in 10 cases, good in 16 cases, fair in 4 cases, and poor in 2 cases.
Locking PFP can provide relative stable fixation to proximal end of osteoporotic femoral fractures, which is a good choice for the treatment of intertrochanteric fractures. It could provide stableness of fractures and bone union, even avoid screws loose or slide out.
探讨股骨近端锁定钢板(PFP)治疗骨质疏松性股骨转子间骨折的疗效并分析失败病例。
采用改良锁定PFP治疗32例Evans I型和II型骨质疏松性股骨转子间骨折患者,其中男性17例,女性15例,平均年龄77.3岁,年龄范围70~86岁。术后根据Harris髋关节评分评估髋关节功能及治疗效果。
32例患者手术时间为(60.5±15.7)分钟,术中出血量为(128.8±73.6)毫升;围手术期输血量为(224.0±72.7)毫升。住院时间14~20天,平均17.2天。所有患者随访6~18个月,平均14.1个月。骨折愈合时间3~6个月,平均3.1个月。1例出现内固定松动及螺钉后退,4例发生泌尿系统感染,1例术后6个月死于心血管疾病,2例术后1年死于脑卒中。未发生切口深部感染、内固定周围骨折、下肢深静脉血栓、内固定断裂、骨不连、严重髋内翻及髋外翻。最终Harris评分为89.74±6.84,优10例,良16例,可4例,差2例。
锁定PFP可为骨质疏松性股骨近端骨折提供相对稳定的固定,是治疗股骨转子间骨折的较好选择。它能提供骨折稳定性及骨愈合,甚至避免螺钉松动或滑出。