目的 分析比较经皮微创椎弓根钉内固定和传统开放式手术治疗脊椎骨折的优劣差异。方法 本研究选择我院2015年2月—2016年6月收治的脊椎骨折患者72例,按照治疗方法的不同将全部患者分成对照组(36例)和实验组(36例),两组患者分别给予传统开放式手术治疗和经皮微创椎弓根钉内固定治疗,对两组患者的临床疗效进行观察分析。结果 在手术时间、手术出血量、切口长度以及住院时间方面,实验组患者均优于对照组(P＜0.05);实验组患者术后的血清肌酸激酶活性低于对照组患者(P＜0.05);治疗后两组患者椎体前缘高度、Cobb's角均优于治疗前(P＜0.05),但是组间比较差异无统计学意义(P＞0.05)。术后两组患者均没有发生椎间隙感染、神经损伤、切口感染等并发症。结论 在对脊椎骨折患者进行治疗时,经皮微创椎弓根钉内固定治疗和传统开放式手术治疗的临床疗效比较类似,但是和传统开放式手术相比较,经皮微创椎弓根钉内固定治疗对患者的损伤更加轻微,术后恢复时间更短。

目的 探讨经皮微创技术应用股骨近端解剖锁定钢板治疗高龄骨质疏松粗隆间骨折的治疗。方法 我院自2009年12月—2013年6月共收治高龄骨质疏松粗隆间骨折56例,男35例,女21例;年龄76～94岁,平均81岁。所有患者应用股骨近端解剖锁定钢板通过经皮微创置入技术治疗。根据Harris髋关节功能评分对治疗效果进行评定。结果 56例手术时间30～90 min,平均45 min;术中失血量70～250 mL,平均110 mL。全部患者获随访,时间6～13.5个月,平均9.5个月。X线骨折愈合时间3～6个月,平均3.5个月。其中优41例,良12例。结论 对于高龄骨质疏松患者粗隆间骨折,采用经皮微创置入股骨近端解剖锁定钢板内固定治疗,具有手术创伤小、出血少、安全可靠等优点,有良好的临床应用价值。

Objective To study the application of proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis (MIPPO) techniques in the treatment of senile osteoporosis curative effect of intertrochanteric fractures in elderly patients. Methods We have treated 56 elderly patients of senile osteoporosis intertrochanteric fractures in December 2009 to June 2013, including 35 male and 21 female cases, aged 76~94, the average of 81. All patients were applied in the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology according to Harris hip joint function scale curative effect. Results 56 cases of operation time 30~90 min, an average of 45 min. Intraoperative blood loss was 70~250 ml, an average of 110 ml. All patients received follow-up from 6 to 13.5 months, an average of 9.5 months. The X-ray fracture healing time was from 3~6 months, 3.5 months on average. According to the Harris hip joint function scale: 41 cases was excellent, 12 cases was good. Conclusion For the senile osteoporosis intertrochanteric fracture, using the proximal femur anatomic locking plate with minimally invasive percutaneous plate osteosynthesis technology can make minimal trauma, less bleeding reliable fixation,and has good clinical application value.