应用MIPPO结合LCP治疗股骨粗隆间及粗隆下粉碎骨折

目的探讨应用微创经皮钢板固定法,结合锁定加压钢板治疗股骨粗隆间及粗隆下粉碎性骨折的临床疗效。方法采用骨折远近端小切口入路,在C型臂X线机透视下复位骨折,股骨近端锁定加压钢板插入经骨膜外隧道横跨骨折端进行内固定治疗股骨粗隆间及粗隆下粉碎性骨折37例,对37例患者随访资料进行分析并评定疗效。结果本组手术切口远端长为4.0-7.0 cm,平均5.0 cm,近端7.0-11.0 cm,平均9.0 cm;手术时间45-120 min,平均60min;出血150-300 mL,平均180 mL,术中均无输血;住院天数为7-15 d,平均12 d。全部病例随访4-22个月,平均8.8个月,骨折于3-6个月骨性愈合,平均3.6个月。Sanders髋关节功能评分系统评分,优（50-60分）28例,良（45-54分）7例,差（35-44分）2例,优良率94.59%。结论微创经皮钢板内固定技术结合锁定钢板内固定手术简便,创伤小,并发症少,疗效好,是治疗股骨粗隆间及粗隆下粉碎性骨折较为有效的方法。

MIPPPO and LCP for Fixation of Intertrochanteric and Subtrochanteric Comminuted Fractures

Objective To investigate the clinical effect of minimally invasive percutaneous plate osteosynthsis and locking compression plate for fixation of intertrochanteric and subtrochanteric comminuted fractures.Methods Under fluoroscopy guidance,the minimally invasive incision and reduction,37 cases of intertrochanteric and subtrochanteric comminuted fractures were treated with MIPPO and LCP,and all cases were followed up for evaluating the clinical effect.Results The mean length of the distal incision was 5.0 cm（range from 4.0 to 7.0）,the proximal incision was 9.0 cm（range from 7.0 to 11.0）.The mean time of operation was 60 min（range from 45 to 120）.The mean blood loss during operation was 180 mL（range from 150 to 300）,no blood transfusion.The mean hospital day was 12 days（range from 7 to15）.The mean duration of follow-up was 8.8 months（range from 4 to 22）.The mean time of the bone union was 3.6 months（range from 3 to 6）.According to Sanders traumatic hip rating scale,28 cases were excellent,7 cases were good and 2 cases were poor,the excellent and good rate was 94.59%.Conclusion Treatment of intertrochanteric and subtrochanteric comminuted fractures with MIPPO and LCP has advantages of operative convenience,minimal invasive,stable fixation and little complication.It is an effective method for treating intertrochanteric and subtrochanteric comminuted fractures at present.