股骨近端髓内钉-螺旋刀片治疗成人股骨转子间骨折

The Outcome of Proximal Femoral Nail Antirotation in Treatment of Adult Intertrochanteric Fractures

[目的]探讨股骨近端髓内钉-螺旋刀片(PFNA)治疗成人股骨转子间骨折的疗效。[方法]自2006年7月～2007年7月,采用闭合或有限切开复位,PFNA固定治疗25例成人股骨转子间骨折患者。[结果]患者均获22～32个月随访,切口均I期愈合,无主钉及锁钉松动、断裂,螺旋刀片切割、退出,股骨头缺血性坏死等并发症。骨折均获骨性愈合,平均愈合时间17.1周。髋关节功能Harris评分:优16例,良7例,可2例。[结论]PFNA治疗成人股骨转子间骨折具有微创,操作简捷,固定可靠等特点,近期疗效满意,但仍具有一定的术中并发症发生率,需要引起重视。

[Objective]To report the preliminary outcome of proximal femoral nail antirotation(PFNA) fixation of intertrochanteric and fractures of adults.[Methods]From July 2006 to July 2007,25 cases of intertrochanteric fractures were fixed by PFNA.The recorded clinical data were reviewed to analyze functions of the hip joint and the complications.[Results]All patients were followed up for 22 to 32 months and had a complete healing of their fractures with an average of 17.1 weeks.No infection,nonunion,cut-out of helical blade,failure of nails were found.According to the Harris scoring system,there was excellent in 16 cases,good in 7 cases,fair in 2 cases.[Conclusion]PFNA has the advantages of less invasive,convenient manipulation,stable fixation and results in satisfactory outcomes at a short clinical phase.But PFNA has a certain degree of incidence of intraoperative complications which require additional attention.