PFNA内固定治疗老年股骨转子间骨折

Analysis of the clinical effect of intertrochanteric fractures of the femur in old patients with internal fixation of PFNA

目的探讨股骨近端螺旋刀片抗旋髓内钉(proximal femoral nail antirotation blade,PFNA)在股骨转子间骨折中的运用,评价PFNA的临床疗效。方法回顾性分析2008年3月～2011年3月采用国产PFNA内固定治疗且随访时间超过10个月的股骨转子间骨折24例病例资料。按Evans分型:II型5例,Ⅲ型9例,Ⅳ型8例,Ⅴ型2例。采用C臂透视下切开复位PFNA内固定术,记录患者手术时间,术中出血,术后引流,以及术后1、3、6、9、12个月髋关节功能和X线片。结果所有患者获得10～12个月随访,平均手术时间70.5min,术中出血平均280.6ml,术后平均引流102.5ml,平均15.5周骨折全部愈合,所有患者髋关节功能良好,无内固定松动、断裂、切割及股骨疲裂骨折等并发症。结论 PFNA具有操作相对简单,创伤小,符合生物力学原则,固定可靠稳定,下床活动早,并发症少等优点。是老年股骨转子间骨折的一种良好的内固定方法。

Objective To investigate the clinical effect of anti-rotating spiral blade proximal femoral nail PFNA in the treatment of intertrochanteric fractures of the femur in old age patients.Methods 24 cases of intertrochanteric fractures of the femur treated with PFNA in our hospital from March 2008 to March 2011 were studied retrospectively.All patients were followed until union or a minimum of ten months.Operative time,blood loss,and postoperative drainage were recorded.Results All patients were followed-up until union or a minimum of ten months.The average operative time were 70.5 minutes,mean blood loss was 280.6ml,and the average postoperative drainage was 102.5ml.Good hip function were obtained in all patients.There were no complications.Conclusion Surgical treatment of intertrochanteric femoral fractures with PFNA can result in excellent reductions and a high union rate.Careful attention to detail is important to perform these maneuvers with minimal additional soft-tissue disruption.