CAJ | 학술논문

目的：探讨股骨近端解剖锁定钢板微侵入经皮钢板植入技术（minimally invasive percutaneous plate osteosynthesis， MIPPO）治疗老年人股骨粗隆间骨折。方法2009年1月至2010年2月共收治32例股骨粗隆间骨折患者。男13例，女19例；年龄60~86岁，平均68岁。按Evans分型：Ⅰ型1例，Ⅱ型6例，ⅢA型14例，ⅢB型3例，Ⅳ型8例。32例患者中有高血压病12例、糖尿病8例、脑梗死12例、慢性支气管炎5例。所有患者行股骨近端解剖锁定钢板结合MIPPO技术手术治疗。结果全部患者获得随访，随访时间9~18个月，平均11个月。32例患者手术时间45~80min，平均手术时间（45±16）min；术中出血量为60~1l0ml，平均（80±10）ml；全部患者围手术期内无1例输血。开始负重时间4~8周，骨折愈合时间8~16周。全部病例都获得骨折愈合，无髋内翻、螺钉穿出或退钉等并发症发生。Harris髋关节经手术治疗后功能评分，优24例、良8例。结论对于老年人股骨粗隆间骨折，股骨近端解剖锁定钢板结合MIPPO技术手术治疗具有创伤小、手术时间短、出血少、操作简便，有利于患者的康复，具有良好的临床应用前景。
목적：탐토고골근단해부쇄정강판미침입경피강판식입기술（minimally invasive percutaneous plate osteosynthesis， MIPPO）치료노년인고골조륭간골절。방법2009년1월지2010년2월공수치32례고골조륭간골절환자。남13례，녀19례；년령60~86세，평균68세。안Evans분형：Ⅰ형1례，Ⅱ형6례，ⅢA형14례，ⅢB형3례，Ⅳ형8례。32례환자중유고혈압병12례、당뇨병8례、뇌경사12례、만성지기관염5례。소유환자행고골근단해부쇄정강판결합MIPPO기술수술치료。결과전부환자획득수방，수방시간9~18개월，평균11개월。32례환자수술시간45~80min，평균수술시간（45±16）min；술중출혈량위60~1l0ml，평균（80±10）ml；전부환자위수술기내무1례수혈。개시부중시간4~8주，골절유합시간8~16주。전부병례도획득골절유합，무관내번、라정천출혹퇴정등병발증발생。Harris관관절경수술치료후공능평분，우24례、량8례。결론대우노년인고골조륭간골절，고골근단해부쇄정강판결합MIPPO기술수술치료구유창상소、수술시간단、출혈소、조작간편，유리우환자적강복，구유량호적림상응용전경。
Objective To explore the treatment of intertrochanteric fracture proximal end lock plate combined with MIPPO Anatomy(minimally invasive percutaneous plate osteosynthesis)technique in the treatment of steel plate in 16 cases. Methods From January 2009 to February of 2010, 32 cases of intertrochanteric fracture patients were enrolled. 13 cases of men and 19 cases of women. Age 60~86 years old with an average of 68 years old. According to Evans points type:1 patients ofⅠtype ,Ⅱtype in 6,Ⅲ14 cases of type A,type BⅢin 3,8 cases ofⅣtype. 32 cases of patients with hypertension 12 cases,diabetes 8 cases, cerebral infarction in 12 cases,chronic bronchitis in 5 patients. All of the patients after proximal femoral anatomy locking plate MIPPO technology combined with surgical treatment. Results All patients were followed up,follow-up time ranged from 9 to 18 months with an average of 11 months. Operation time was 45~80min with an average of(45±16)min;intraoperative bleeding was 60~1l0ml with an average of(80±10)ml;no transfusion was applied.The time to start loading was 4-8 weeks,the time for fracture healing was 8~16weeks. All cases have been fracture healing,no Coxa Vara,fixation screw wear out or with drawal of nails and other complications. For Harris hip score of function after operation,excellent standard of 24 cases,8 cases of benign. Conclusions For intertrochanteric fracture,proximal femoral anatomical locking plate combined with MIPPO technology surgery had less trauma,short bleeding time,and the operation was small and simple,which all contribute to the rehabilitation of patients with good clinical application.