股骨近端抗旋髓内钉治疗老年股骨粗隆间骨折

Proximal femoral nail anti-rotation internal fixation for intertrochanteric fracture in elderly patients

目的探讨股骨近端抗旋髓内钉(PFNA)治疗老年股骨粗隆间骨折的方法及疗效。方法采用股骨近端抗旋髓内钉内固定治疗21例老年股骨粗隆间骨折。骨折按AO分型:A1型2例,A2型17例,A3型2例。合并糖尿病2例,心肺疾病6例。以骨折部位有四分之三区域骨小梁通过为愈合标准。结果骨折全部愈合。根据Harris髋关节功能评分:优12例(大于等于90分),较好5例(80～89分),良2例(70～79分),差2例(小于70分),总体优良率90.5%。无褥疮、下肢静脉血栓、髋内翻等并发症发生。结论股骨近端抗旋髓内钉的设计符合生物力学原理;其治疗老年股骨粗隆间骨折具有操作简单、创伤小、固定牢固、并发症少、疗效确切等优点。

Objective To discuss the efficacy of proximal femoral nail anti-rotation（PFNA） internal fixation for intertrochanteric fracture in elderly patients.Methods Totally 21 elderly patients with intertrochanteric fracture were treated with PFNA internal Fixation.According to AO classification of fractures,there were 2 cases of A1,17 cases of A2 and 2 cases of A3.Two cases were complicated with diabetes mellitus and six cases with cardiorespiratory disease.Results All fractures were recovered well.According to Harris evaluation for function of hip joint,there were 12 cases of excellent（higher than 90 scores）,5 cases of fair（80～89 scores）,2 cases of good（70～79 scores） and 2 cases of bad（lower than 70 scores）,the total excellent and fair rate amounting to 90.5%.No case of bedsore,lower limb venous thrombus and coxa vara was observed.Conclusion The design of PFNA is in consistent with biodynamics and PFNA has the advantages of simple operation,less invasiveness,firm fixation,fewer complications and obvious therapeutic effects.