经皮加压钢板与股骨近端防旋髓内钉治疗外侧壁危险型股骨粗隆间骨折的病例对照研究
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韦旭明 WEI Xu-ming 苏州大学附属无锡第九医院骨科, 江苏 无锡 214062 Department of Orthopaedics, No.9th Hospital of Wuxi Affilated to Soochow University, Wuxi 214062, Jiangsu, China wuxiwxm@hotmail.com 
孙振中 SUN Zhen-zhong 苏州大学附属无锡第九医院骨科, 江苏 无锡 214062 Department of Orthopaedics, No.9th Hospital of Wuxi Affilated to Soochow University, Wuxi 214062, Jiangsu, China  
宋骁军 SONG Xiao-jun 苏州大学附属无锡第九医院骨科, 江苏 无锡 214062 Department of Orthopaedics, No.9th Hospital of Wuxi Affilated to Soochow University, Wuxi 214062, Jiangsu, China  
期刊信息:《中国骨伤》2013年,第26卷,第12期,第981-984页
DOI:10.3969/j.issn.1003-0034.2013.12.003
基金项目:
中文摘要:

目的:比较经皮加压钢板(percutaneous compressing plating,PCCP)与股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)治疗外侧壁危险型股骨粗隆间骨折的临床疗效.

方法:自2007年9月至2010年6月,对 43例外侧壁危险型股骨粗隆间骨折患者根据内固定方式分别采用PCCP和PFNA治疗.其中 PCCP组22例,男9例,女13例;年龄60~86岁,平均(68.4±17.6)岁;A2.2型13例,A2.3型9例.PFNA组21例,男7例,女14例;年龄57~93岁,平均(67.7±20.1)岁;A2.2型10例,A2.3型11例.观察比较两组术中失血量、手术时间、住院时间、骨折愈合时间、并发症及术后1年Harris评分情况.

结果:43例患者获得随访,平均随访18.4个月(12~22个月),全部患者获骨折愈合,恢复外伤前行走功能.两组术中失血量、手术时间、住院时间、骨折愈合时间、并发症、术后1年Harris评分比较差异无统计学意义(P>0.05).两组均有1例出现大粗隆顶端骨块上移、1例患髋外展无力.PCCP组1例出现螺钉断裂,PFNA组1例出现髋关节疼痛.

结论:PCCP以及PFNA均能有效治疗外侧壁危险型股骨粗隆间骨折,但对于外侧壁顶端骨块移位的影响和治疗策略有待于进一步研究.
【关键词】股骨  骨折  骨折固定术,内  病例对照研究
 
Case-control study on percutaneous compressing plating and proximal femoral nail antirotation in treating intertrochanteric fracture with risk external wall
ABSTRACT  

Objective: To compare clinical effects between percutaneous compressing plating(PCCP)and proximal femoral nail antirotation(PFNA) for the treatment of patients with intertrochanteric fracture with risk external wall.

Methods: From September 2007 to June 2010,43 patients with intertrochanteric fracture with risk external wall were treated by PCCP or PFNA according to different kinds of internal fixations. There were 22 cases in PCCP,including 9 males and 13 females with an average age of 68.4(ranged,60 to 86) years old,and 13 cases with type A2.2 and 9 cases with type A2.3;while 21 cases in PFNA,including 7 males and 14 females with an average age of 67.7(ranged,57to 93) years old,and 10 cases with type A2.2 and 11 cases with type A2.3. Blood loss,operation time,hospital stay,fracture healing time,complications and Harris score after 1 years' following-up were observed and compared.

Results: All patients were followed up for 12 to 22 (means 18.4) months,and all patients were obtained fracture healing,and recovered walking ability as before injury. There were no significant differences in blood loss,operation time,hospital stay,fracture healing time,complications and Harris score after 1 years' following-up(P>0.05). One case occurred displacement on the top of greater trochanter,and 1 case injuried weakness of hip abduction. One case occurred screw breakage in PCCP,while 1 case occurred hip joint pain in PFNA.

Conclusion: Both of PCCP and PFNA in treating patients with intertrochanteric fracture with risk external wall can receive good clinical effects,while the effects and therapy strategy for displacement of bone on the top of lateral wall should further study.
KEY WORDS  Femur  Fractures  Fracture fixation, internal  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:韦旭明,孙振中,宋骁军.经皮加压钢板与股骨近端防旋髓内钉治疗外侧壁危险型股骨粗隆间骨折的病例对照研究[J].中国骨伤,2013,26(12):981~984
英文格式:WEI Xu-ming,SUN Zhen-zhong,SONG Xiao-jun.Case-control study on percutaneous compressing plating and proximal femoral nail antirotation in treating intertrochanteric fracture with risk external wall[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(12):981~984
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