Watson J T, Moed B R, Cramer K E, Karges D E
Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI 48202, USA.
Clin Orthop Relat Res. 1998 Mar(348):79-86.
The Medoff sliding plate was designed to achieve compression along the femoral neck and the longitudinal axis of the femoral shaft theoretically to improve the treatment of intertrochanteric hip fractures. The Medoff sliding plate was compared with a standard compression hip screw in a randomized, prospective study for the fixation of 160 stable and unstable intertrochanteric fractures with an average followup of 9.5 months (range, 6-26 months). Overall, 91 fractures were treated using the compression hip screw and 69 were treated with the Medoff sliding plate. Stable fracture patterns (46) united without complication in both treatment groups. Unstable fractures (114) had an overall failure rate of 9.6%, 14% (nine patients) with the compression hip screw and 3% (two patients) with the Medoff plate; this difference was significantly different. The time to union for the 114 unstable fractures was not significantly different between the two devices. For all patients, no differences in lengths of hospitalization, return to ambulatory status before fracture, postoperative living status, or postoperative pain was observed between the two device groups. Use of the Medoff plate for all fracture types was associated with a significantly higher amount of blood loss and operating time.
梅多夫滑动钢板的设计目的是理论上沿股骨颈和股骨干纵轴实现加压，以改善股骨转子间髋部骨折的治疗。在一项随机、前瞻性研究中，将梅多夫滑动钢板与标准加压髋螺钉用于固定160例稳定和不稳定的股骨转子间骨折，平均随访9.5个月（范围6 - 26个月）。总体而言，91例骨折采用加压髋螺钉治疗，69例采用梅多夫滑动钢板治疗。两个治疗组中，稳定骨折类型（46例）均愈合且无并发症。不稳定骨折（114例）的总体失败率为9.6%，加压髋螺钉组为14%（9例患者），梅多夫钢板组为3%（2例患者）；这一差异具有显著性。两种器械治疗114例不稳定骨折的愈合时间无显著差异。对于所有患者，两个器械组在住院时间、骨折前恢复行走状态、术后生活状态或术后疼痛方面均未观察到差异。使用梅多夫钢板治疗所有骨折类型均伴有显著更多的失血量和手术时间。
