PFN-A治疗老年骨质疏松性股骨转子间骨折的初步观察

The effects analysis of femoral intertrochanteric fractures of aged osteoporosis treated with PFN-A

目的评价PFN-A治疗老年骨质疏松性股骨转子间骨折的初步临床疗效。方法12例老年骨质疏松性股骨转子间骨折患者。按AO的Muller分类31-A2型8例,31-A3型4例,采用PFN-A治疗,统计术中失血量、手术时间、观察骨折愈合及髋关节功能恢复情况。结果术中平均失血量90ml,平均手术时间50min。术后2-8个月随访,10例骨折达临床愈合,2例因仅随访2个月尚待进一步观察。髋关节功能评价总优良率为91.7%,无感染、内固定失败,无股骨头缺血坏死及髋内翻畸形。结论PFN-A治疗老年骨质疏松性股骨转子间骨折具有固定牢稳、微创、并发症少的特点,但对骨折断端加压程度有限,对于一些严重粉碎性骨折难以闭合复位的患者有一定的局限性。

Objective To evaluate the therapeutic effect of femoral intertrochanteric fractures treated with Proximal Femoral Nail-A （PFN-A） in aged osteoporosis. Methods 12 cases of femoral intertrochanteric fractures of aged osteoporosis treated with PFN-A were analyzed. Among the 12 cases, eight were type 31-A2 and 4 were type 31- A3 by AO Muller＇s classification. The blood loss, operation time, fracture healing and functional recovery of the hip joint were observed. Results The mean blood loss was 90ml, and the mean operation time was 50min. All cases got followed-up for 2 to 8 months after operation. Ten fractures showed clinical healing, but another 2 cases needed to be observed because of the short follow-up time. There were no infection and failure of internal fixation in all cases with a 91.7% excellent and good function recovery rate of the hip joints and no report of ischemia and necrosis of femoral head, and no malformation of hip varus. Conclusion The clinical treatment of femoral intertrochanteric fractures of aged osteoporosis with PFN-A is stable, miniinvasive and almost free from complications, which is applicable to patients of osteoporosis. But PFN-A has its limitations of less enough axial compressive stress to the fracture.