近端髓内钉在治疗股骨反转子间骨折中的应用

Proximal femoral nail in the treatment of reverse oblique intertrochanteric femoral fractures

目的探讨近端髓内钉在治疗股骨反转子间骨折中的临床价值。方法选择反转子间骨折患者38例行近端髓内钉内固定术，其中男18例，女20例，年龄40—82岁，平均52．2岁，AO／OTA31—A3-I型13例，AO／OTA31．A3-II型10例，AO／OTA31-A3．III型15例，并对此38例患者的临床资料进行系统性回顾分析。结果38例患者全部得到随访，随访时间4个月-19个月，平均12．7个月。平均手术操作时间52min，平均出血量295ml，全部患者骨折愈合，平均愈合时间8．5周。Harris髋关节评分67～97分，平均80．6分。38例患者均无术中并发症出现。术后无内置物断裂、松动、移位。结论近端髓内钉是治疗股骨反转子间骨折的一种较为理想的方法。

Objective To investigate the clinical value of proximal lemoral nan ~ rr l~ ） on re- verse oblique inter troehanteric femoral fractures. Methods Thirty-eight patients with reverse oblique intertrochanteric femoral fractures were treated with proximal femoral nailing, of Which 18 cases of male, 20 cases of female, aged from 40 to 82 years old, average age was 52.2 years old. AO/OTA classifica- tion： 13 cases of AO/OTA 31-A3- I type, 10 cases of AO/OTA 31-A3-Ⅱ type, 15 cases of AO/OTA 31-A3-Ⅲ type. And the clinical data of these 38 cases were retrospectively reviewed. Results All 38 cases were followed up for 4 to 19 months, an average of 12.7 months. The mean duration of surgery was 52 minutes and the average amount of bleeding was 295 ml. All fractures healed and the mean healing time was 8.5 weeks. Harris hip score were 67 to 97, and the mean score was 80.6. No intraoperative complications occured in all the 38 cases. No breakage, loose, or shift of the PFN postoperation. Conclusions The intramedullary nailing with proximal femoral nails is an ideal method in the treatment of reverse oblique intertrochanteric femoral fractures.