关键词: 股骨干骨折, 经皮微创钢板, 交锁髓内钉, 成人, 卫生经济学评价

Abstract: Objective To compare the advantages of minimally invasive percutaneous internal fixation of plate versus interlocking intramedullary nail for femoral shaft fractures in adults from the point of health economics，providing a rationale for treating femoral shaft fractures.Methods Seventy adult patients with freshly closed femoral shaft fractures（AO classification：A to B type） who were admitted to No.2 Hospital of Baoding between January 2014 and March 2015 were selected in a retrospective，matching(1:1) and controlled manner.Based on different surgical procedures，patients who received minimally invasive percutaneous plate fixation and interlocking intramedullary nail internal fixation were assigned to the MIPPO group and the intramedullary nail group respectively.Those patients enrolled were recorded in Excel regarding health (total incision length，operation time，intraoperative blood loss，postoperative hospital stay，union time and complications) and economic parameters (postoperative hospitalization expenses and rates of returning to work at 6 and 12 months postoperatively).Differences in intergroup data were compared with SPSS 20.0. Results (Ⅰ) Completion of cases:The patients enrolled were followed up for (12-25) months;four patients were excluded from the MIPPO group and three the intramedullary nail group，respectively.(Ⅱ) Comparison of health parameters:Both groups showed comparative clinical response rate (93.55% vs 90.63%)，incidence of complications，total incision length，and postoperative hospital stays (all P＞0.05).the MIPPO group showed shorter operation time，lower intraoperative blood loss and faster union than the intramedullary nail group (P＜0.05).(Ⅲ) Comparison of economic parameters:The MIPPO group had a higher rate of returning to work at 6 months than the intramedullary nail group (61.29% vs 40.63%，P＜0.05).Both groups showed comparative postoperative hospitalization expenses and rate of returning to work at 12 months (P＞0.05). Conclusion Both minimally invasive percutaneous internal fixations of plate and interlocking intramedullary nail can effectively treat adult patients with freshly closed femoral shaft fractures（A to B type）,minimally invasive percutaneous plate fixation is characterized by less bleeding，short operation time，fast union and a high rate of early returning to work.

Key words: femoral shaft fractures, minimally invasive percutaneous plate, interlocking intramedullary nail, adult, health economic evaluation