PFN治疗老人股骨粗隆间不稳定型骨折

Treatment of Unstable Intertrochanteric Femoral Fracture in Elderly with Proximal Femoral Nail

目的:评价PFN股骨近端骨髓内钉用于治疗老年人股骨粗隆间不稳定型骨折临床疗效。方法:2003年1月-2004 年2月采用PFN内固定治疗老年人股骨粗隆间不稳定型骨折38例,患者平均年龄为71岁(63岁-82岁);按A0分类:31-A2型27例,31-A3型11例。结果:本组患者手术时间为38分-75分,平均46分;术中出血量为60ml-200ml,平均80ml;1例术后合并肺部感染转科治疗,其余无明显并发症.随访4月-12个月,平均3.7个月;骨折平均愈合时间为3个月。采用parker活动评分法评估患者术后行走能力,9例(23.6%)恢复至伤前的90%。结论:闭合复位PFN内固定是治疗老年人股骨粗隆间不稳定型骨折的良好方法。

Objective: To appraise the clinical results of the treatment of unstable intertrochanteric femoral fractures in the elderly with proximal femoral nail (PFN). Methods: 38 cases of unstable intertrochanteric fracture at age of 63-82 (mean 71) years were treated with closed reduction and intramedullary fixation using PFN from February 2003 to February 2004. According to Ao-ASIF classification, 27 (71.0%) fractures were classified as 31-A2 and 11 (28.9%) as 31-A3. Results: The operative duration in this sense was 38-75 (mean 46) minutes with operative blood loss of 60-200ml mean 80ml. No serious complication occurred post operatively, except one with pulmonary infection. A follow-up of 4-12 months (mean 3.7 months) revealed a mean fracture healing time of 3 months. Walking ability was assessed by the mobility score of paker and palmer, 9 patients (23.6%) recovered to their level before the injury while 21 patients (55.2%) recovered to 90% of their previous walking ability. Conclusion: Closed reduction and ternal fixation with PFN in an effective method of treatment for unstable intertrochanteric femoral fracture in the elderly.