CAJ | 학술논문

目的：观察经皮微创钢板内固定(MIPPO)技术结合锁定加压钢板(LCP)方式与股骨近端防旋髓内钉(PF鄄NA)治疗股骨粗隆间骨折(IFF)效果差异，观察患者骨折愈合情况。方法选择2010年1月~2013年10月深圳市龙岗中心医院收治的IFF患者60例，随机分为观察组及对照组，每组各30例。观察组采取MIPPO技术结合LCP方式治疗，对照组采取PFNA治疗。术后两组患者进行系统康复训练，随访1年，根据Harris髋关节评分评估患者髋关节功能恢复情况，比较两组疗效差异。结果观察组手术时间、出血量、负重时间、骨折愈合时间分别为(64.7±11.4)min、(267.9±79.4)mL、(83.4±7.9)d、(17.5±1.1)周，均优于对照组[(79.4±12.1)min、(336.2±84.5)mL、(103.3±9.5)d、(18.9±1.2)周]，差异有统计学意义(P<0.05)；观察组住院天数[(15.9±2.3)d]与对照组[(16.7±2.5)d]比较，差异无统计学意义(P>0.05)。观察组Harris髋关节评分优22例(73.3%)，良5例(16.7%)，一般2例(6.7%)，差1例(3.3%)，对照组分别为16例(53.3%)、5例(16.7%)、5例(16.7%)、4例(13.3%)，观察组优良率[90.0%(27/30)]明显优于对照组[70.0%(21/30)]，差异有统计学意义(P<0.05)；观察组不良反应发生率[6.7%(2/30)]与对照组[10.0%(3/30)]比较，差异无统计学意义(P>0.05)。结论 MIPPO技术结合LCP治疗IFF生物力学稳定，有助于术后髋关节功能恢复，且不良反应少，安全性较高，临床疗效较佳。
목적：관찰경피미창강판내고정(MIPPO)기술결합쇄정가압강판(LCP)방식여고골근단방선수내정(PF견NA)치료고골조륭간골절(IFF)효과차이，관찰환자골절유합정황。방법선택2010년1월~2013년10월심수시룡강중심의원수치적IFF환자60례，수궤분위관찰조급대조조，매조각30례。관찰조채취MIPPO기술결합LCP방식치료，대조조채취PFNA치료。술후량조환자진행계통강복훈련，수방1년，근거Harris관관절평분평고환자관관절공능회복정황，비교량조료효차이。결과관찰조수술시간、출혈량、부중시간、골절유합시간분별위(64.7±11.4)min、(267.9±79.4)mL、(83.4±7.9)d、(17.5±1.1)주，균우우대조조[(79.4±12.1)min、(336.2±84.5)mL、(103.3±9.5)d、(18.9±1.2)주]，차이유통계학의의(P<0.05)；관찰조주원천수[(15.9±2.3)d]여대조조[(16.7±2.5)d]비교，차이무통계학의의(P>0.05)。관찰조Harris관관절평분우22례(73.3%)，량5례(16.7%)，일반2례(6.7%)，차1례(3.3%)，대조조분별위16례(53.3%)、5례(16.7%)、5례(16.7%)、4례(13.3%)，관찰조우량솔[90.0%(27/30)]명현우우대조조[70.0%(21/30)]，차이유통계학의의(P<0.05)；관찰조불량반응발생솔[6.7%(2/30)]여대조조[10.0%(3/30)]비교，차이무통계학의의(P>0.05)。결론 MIPPO기술결합LCP치료IFF생물역학은정，유조우술후관관절공능회복，차불량반응소，안전성교고，림상료효교가。
Objective To observe the effect difference of minimally invasive percutaneous plate osteosynthesis (MIPPO) technology combined with locking compression plate (LCP) and proximal femoral nail antirotation (PFNA) in the treat-ment of intertrochanter fracture of femur (IFF); and to observe the conditions of fracture healing of patients. Methods 60 patients with IFF in Longgang Central Hospital of Shenzhen City from January 2010 to October 2013 were selected and divided into observation group and control group according to the random number method with 30 cases in each group. The observation group was treated with MIPPO technology combined with LCP therapy, and the control group was performed with the PFNA treatment. After the operation, the system of rehabilitation training was performed with the two groups and followed up for 1 year. The hip function recovery of all patients were evaluated by the Harris hip score. The curative effect difference of two groups were compared. Results The operation time, amount of bleeding, load time, fracture healing time were in observation group were (64.7±11.4) min, (267.9±79.4) mL, (83.4±7.9) d, (17.5±1.1) weeks re-spectively, and they were all better than those in control group [(79.4±12.1) min, (336.2±84.5) mL, (103.3±9.5) d, (18.9±1.2) weeks], the differences were statistically significant (P< 0.05); but the difference of length of stay between the observation group [(15.9±2.3) d] and the control group [(16.7±2.5) d] was not statistically significant (P> 0.05). 22 cases (73.3%) of excellent grade, 5 cases (16.7%) of good grade, 2 cases (6.7%) of ordinary grade and 1 case (3.3%) of poor grade were found in observation group ac-cording to Harris hip score; 16 cases (53.3%) of excellent grade, 5 cases (16.7%) of good grade, 5 cases (16.7%) of or-dinary grade, 4 cases (13.3%) of poor grade were found in control group. The excellent and good rate in observation group [90.0% (27/30)] was higher than that in the control group [70.0% (21/30)], the difference was statistically signifi-cant (P<0.05). The difference of adverse reaction incidence between observation group [6.7% (2/30)] and control group [10.0% (3/30)] was not statistically significant (P> 0.05). Conclusion The biomechanical is more stable after the com-bination of MIPPO technology and LCP in the treatment of IFF biomechanics, and can help to restore the function of hip and has less adverse reaction and higher security, the clinical curative effect is better.