唐天华;谭文成;唐三元;杨辉;朱亚平;黄馨霈;

• 1:暨南大学附属珠海医院
• 2:珠海市人民医院创伤骨科
• 3:澳门仁和医疗中心

摘要(Abstract)：

[目的]对经皮加压钢板(PCCP)与动力髋螺钉(DHS)内固定治疗股骨转子间骨折疗效与并发症进行评价。[方法]按照Cochrane系统评价的方法,计算机检索下列数据库:Medline、Pubmed、SPINGER、John Wiley、Science Direct、EBSCO、CNKI、万方数数据库,并采用手工检索等方法收集文献。检索时间为1998年1月~2013年8月。收集所有相关随机对照试验,采用Cochrane协作网提供的软件Revman 5.1进行Meta分析。[结果]经过筛选,共纳入5个临床随机对照试验463例患者。Meta分析显示PCCP组与DHS组在手术时间(95%CI:-26.01~4.05,P=0.15)、住院时间(95%CI:-1.79~1.25,P=0.73)、死亡率(95%CI:0.37~1.02,P=0.06)、置入物相关并发症(95%CI:0.29~1.82,P=0.49)和再手术率(95%CI:0.41~3.05,P=0.83)上无明显统计学差异。但两组患者出血量(95%CI:-173.84~-4.81,P=0.04)和输血量(95%CI:-0.53~-0.07,P=0.01)有明显差异,PCCP组较DHS组明显减少。[结论]PCCP与DHS相比能减少出血和输血量,但在其他方面基本相同。由于病例数的限制,尚需要更多更高质量的临床随机对照试验来评价PCCP的效果。

关键词(KeyWords)： 经皮加压钢板;动力髋螺钉;转子间骨折;疗效;Meta分析

Abstract:

Keywords:

基金项目(Foundation): 澳门科学技术发展基金(编号:072/2013/A);; 广东省社会发展科技计划项目(编号:2013B021800115);; 珠海市科技局计划项目(编号:2014D0401990026)

作者(Author): 唐天华;谭文成;唐三元;杨辉;朱亚平;黄馨霈;

Email:

DOI:

参考文献(References)：

• [1]Lyles KW,Colón-Emeric CS,Magaziner JS,et al.Zoledronic acid and clinical fractures and mortality after hip fracture[J].N Engl J Med,2007,357(18):1799-1809.
• [2]Cole PA,Bhandari M.What's new in orthopaedic trauma[J].J Bone Joint Surg Am,2005,87(12):2823-2838.
• [3]Saarenp I,Heikkinen T,Ristiniemi J,et al.Functional comparison of the dynamic hip screw and the Gamma locking nail in trochanteric hip fractures:a matched-pair study of 268 patients[J].Int Orthop,2009,33(1):255-260.
• [4]Ropars M,Mitton D,Skalli W.Minimally invasive screw plates for surgery of unstable intertrochanteric femoral fractures:a biomechanical comparative study[J].Clin Biomech,2008,23(8):1012-1017.
• [5]Green S.Cochrane handbook for systematic reviews of interventions version 5.1.0 updated March 2011[EB/OL].Cochrane Collaboration,2011.
• [6]Brandt SE,Lefever S,Janzing HMJ,et al.Percutaneous compression plating(PCCP)versus the dynamic hip screw for pertrochanteric hip fractures:preliminary results[J].Injury,2002,33(5):413-418.
• [7]Janzing HM,Houben BJ,Brandt SE,et al.The gotfried percutaneous compression plate versus the dynamic hip screw in the treatment of pertrochanteric hip fractures:minimal invasive treatment reduces operative time and postoperative pain[J].J Trauma,2002,52(2):293-298.
• [8]Peyser A,Weil YA,Brocke L,et al.A prospective,randomised study comparing the percutaneous compression plate and the compression hip screw for the treatment of intertrochanteric fractures of the hip[J].J Bone Joint Surg Br,2007,89(9):1210-1217.
• [9]Yang E,Qureshi S,Trokhan S,et al.Gotfried percutaneous compression plating compared with sliding hip screw fixation of intertrochanteric hip fractures:a prospective randomized study[J].J Bone Joint Surg Am,2011,93(10):942-947.
• [10]Kosygan KP,Mohan R,Newman RJ.The Gotfried percutaneous compression plate compared with the conventional classic hip screw for the fixation of intertrochanteric fractures of the hip[J].J Bone Joint Surg Br,2002,84(1):19-22.
• [11]Peyser A,Weil Y,Brocke L,et al.Percutaneous compression plating versus compression hip screw fixation for the treatment of intertrochanteric hip fractures[J].Injury,2005,36(11):1343-1349.
• [12]Giancola R,Antonini G,Delle Rose G,et al.Percutaneous compression plating versus gamma nail for the treatment of pertrochanteric hip fractures[J].Strategies Trauma Limb Reconstr,2008,3(1):9-14.
• [13]Ropars M,Mitton D,Skalli W.Minimally invasive screw plates for surgery of unstable intertrochanteric femoral fractures:a biomechanical comparative study[J].Clin Biomech,2008,23(8):1012-1017.
• [14]Endo Y,Aharonoff G B,Zuckerman J D,et al.Gender differences in patients with hip fracture:a greater risk of morbidity and mortality in men[J].J Orthop Trauma,2005,19(1):29-35.
• [15]Kannegaard PN,van der Mark S,Eiken P,et al.Excess mortality in men compared with women following a hip fracture.National analysis of comedications,comorbidity and survival[J].Age Ageing,2010,39(2):203-209.
• [16]Ma J,Xing D,Ma X,et al.The percutaneous compression plate versus the dynamic hip screw for treatment of intertrochanteric hip fractures:a systematic review and meta-analysis of comparative studies[J].Orthop Traumatol Surg Res,2012,98(7):773-783.