股骨远端微创内固定系统钢板倒置治疗老年股骨转子间骨折的安全性和疗效

发布时间：2019-03-02 21:29

【摘要】：背景:研究显示,微创内固定系统和股骨近端防旋髓内钉有着相同的生物力学强度。目的:观察老年股骨转子间骨折采用股骨远端微创稳定系统钢板倒置手术治疗的安全性和疗效。方法:30例老年股骨转子间骨折采用股骨远端微创内固定系统钢板倒置手术治疗,对手术时间,切口长度,总出血量(术中及术后1d引流量)进行记录。同时采用POSSUM、P-POSSUM评分系统,预测并发症、死亡的情况,评估手术的风险。对术后并发症、死亡患者进行统计并和预测的情况对比,观察微创内固定系统钢板倒置手术治疗的安全性。记录骨折愈合时间,末次Harris评分,观察其疗效。结果与结论:(1)预测POSSUM并发症发生率46.05%,P-POSSUM死亡率发生率为3.93%,实际并发症和死亡率的发生分别为13.3%和0%,并发症差异有显著性意义(P=0.05),死亡率差异无显著性意义(P=1);(2)骨折愈合时间21-32周,末次Harris评分优良率83.3%;(3)结果说明,老年股骨转子间骨折采用股骨远端微创内固定系统钢板倒置手术治疗的手术操作方便,安全性可靠,疗效较好。
[Abstract]:Background: studies have shown that minimally invasive internal fixation systems share the same biomechanical strength as proximal femoral anti-rotating intramedullary nailing. Objective: to observe the safety and efficacy of minimally invasive stable system plate inversion in the treatment of intertrochanteric fractures in the elderly. Methods: thirty elderly patients with intertrochanteric fracture were treated with plate inversion of distal femoral internal fixation system. The operation time, incision length and total bleeding volume (drainage flow during operation and 1 day after operation) were recorded. At the same time, POSSUM,P-POSSUM scoring system was used to predict complications and death, and to assess the risk of surgery. In order to observe the safety of minimally invasive internal fixation system plate inversion operation, the complications and death of patients after operation were statistically compared with those predicted. The time of fracture healing and the final Harris score were recorded and the curative effect was observed. Results & conclusion: (1) the incidence rate of complications in POSSUM was 46.05%, the mortality rate was 3.93%, the actual complications and mortality rates were 13.3% and 0%, respectively. There was significant difference in complications (P < 0.05), but there was no significant difference in mortality (P < 0.05). (2) the fracture healing time was 21-32 weeks, and the excellent and good rate of the last Harris score was 83. 3%; (3) the results showed that the treatment of intertrochanteric fractures in the elderly by plate inversion with distal femoral internal fixation system was convenient, safe and reliable, and the curative effect was good.
【作者单位】：西南医科大学附属中医医院骨伤科;
【分类号】：R687.3

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