股骨近端防旋转髓内钉治疗股骨转子间骨折疗效分析

Evaluation of the curative effect of proximal flemoral nail antirotation on treatment of intertrochanteric fractures

目的观察股骨近端防旋转髓内钉（PFNA）治疗股骨转子间骨折的疗效。方法回顾性分析我院骨科应用股骨近端防旋转髓内钉（PFNA）治疗41例股骨转子间骨折患者的疗效,骨折类型按经典的Evans-Jensen分型结果为：Ⅰ型12例,Ⅱ型19例,Ⅲ型10例;采用闭合复位PFNA内固定术,观察相关手术以及恢复指标。结果手术时间43~129分钟,平均手术时间（78.85±26.69）分钟。手术出血量100~350ml,平均（173.5±78.75）ml。术后首次下地时间3~20天,平均（10.15±5.19）天。根据Sanders髋关节创伤后功能评分,观察组中PFNA髋关节功能优秀26例,良好11例,差4例,总优良率90.24%。结论 PFNA手术时间短,出血少,患者早期下地早,术后患者髋关节功能恢复较好,特别对于不稳定型复杂骨折,本院认为PFNA是目前治疗股骨转子间骨折治疗中比较理想的内固定材料。

Objective To evaluate the curative effect of proximal flemoral nail antirotation（PFNA） on treatment of intertrochanteric fractures.Methods 41 cases of intertrochanteric fracture patients treated with PFNA were analyzed.According to Evans-Jensen classification system,there were 12 cases of type I fracture,19 cases of type II fracture,10 cases of type III fracture.The operation bleeding loss,surgery duration and the time of the first standing up after operation were recorded.The hip function evaluation was evaluated by the Sanders scores.Results The operating time was from 43 minutes to 129 minutes,and the average time is 78.85±26.69 minutes.The bleeding loss was from 100ml to 350ml,and the average loss was 173.5±78.75 ml.The time of the first standing up after operation was from 3 days to 20 days.The average days is 10.15±5.19 days.According to Sanders scores for hip joint function,there were 26 excellent cases,11 good case,4 bad cases in PFNA group.Conclusion For the intertrochanteric fractures,PFNA has the advantage of simple manipulation,less operation bleeding loss,earlier the first standing time,less operation time and better hip function.