摘要
目的探讨经皮加压钢板（percutaneous compression plating,PCCP）治疗老年股骨粗隆间骨折的临床疗效。方法对12例老年骨质疏松股骨粗隆间骨折患者进行PCCP内固定手术,平均年龄75.3岁（69～82岁）。术后进行下肢功能锻炼。观察手术时间、术中使用C型臂透视时间、术中失血量、切口尺寸以及功能恢复情况。结果平均随访10.2（4～12）个月。手术时间（从切皮到缝合）平均为47.8 min（35～75 min）,C型臂X线机透视平均使用时间为51.3秒（30～85秒）,术中平均显性失血为101.7 mL（50～200 mL）,近端切口2～3 cm,远端切口3～4 cm。术后48 h疼痛为60分的有9例（占75%）,口服镇痛药可以控制。术后下肢功能评价优8例,良4例,1例病人术前合并脑梗塞,在拐杖的支持下恢复到术前的运动功能。本组未出现切口感染、深静脉血栓形成、骨不连、钢板螺钉断裂、髋内翻及股骨头坏死等并发症。结论采用PCCP治疗老年骨质疏松性粗隆间骨折具有切口小、出血少,手术时间短、术中透视时间短、术后功能恢复好等特点,是治疗股骨粗隆间骨折的理想固定方式,具有较满意的临床疗效。
Objective To assess the clinical effect of osteoporotic troehanteric hip fractures using the pereutaneous compression plating（PCCP） in elderly patients. Methods 12 osteoporotic intertrochanterie hip fractures were trcated with PCCP,with an average, age at surgery of 75.3 years（range：69 to 82）. Low limb function were undertaken post operation. Surgical time .C-arm time ,blood loss .incision length and the functional recovery were observed. No perioperative complications were noted. All but two palients were ambulatory with weight bearing two days after operation, The postoperative blood transfusion rate was only 25%. No patient was lost to follow-up. We noted 11 deaths （17% ） at the end of follow-up （5 during hospitalisation and 6 during the first 9 months）. The re-operation rate was 4. 5%; Osteosynthesis with the PCCP allows for decreased intraoperative bleeding and minimises injury to muscle and tendon structures. The stability and quality of the construct enable early recovery of patients while limiting morbidity for this type of fracture. Results Average follow up was 10.2 months（range：4 to 12）. The average duration of the operation ＂skin to skin＂ was 47. 8 rain （range：35 to 75 ）with an average duration of fluoroscopy of 51.3 seconds （range：30 to 85）. Mean perioperative blood loss was 101.7 milliliters （range 50 to 200 milliliters）,length of incision 2 to 3 in proximal end ,and 3 to 4 in remote end. 9 patients had taken the pills to reduce ache. Aecess the function recovery ,exccllent in 8 cases （66%） ,good in 3 cases（25%） 1 ease reached to preoperation movement ,with the help of orthosis, No perioperative complications were recorded. Conclusion Useing of the percutaneous compression plating for ostcoporotic intertrochanteric hip fractures in elderly was an ideal method of fixation.
出处
《实用骨科杂志》
2009年第7期498-501,共4页
Journal of Practical Orthopaedics
