防旋股骨近端髓内钉治疗老年股骨转子间骨折

Proximal femoral nail anti-rotation in treating senile patients with femoral intertrochanteric fracture

目的探讨防旋股骨近端髓内钉(PFNA)治疗股骨转子间骨折的效果。方法应用PFNA内固定治疗30例股骨转子间骨折患者。记录术中失血量、X线透视时间和手术时间,观察骨折愈合情况。采用Harris评分评估髋关节功能情况。结果手术时间35～75(60±15)min,术中X线透视时间0.1～0.3(0.2±0.1)min,术中出血量120～180(150±30)ml。患者均获得随访,时间6～18个月,骨折全部愈合。无髋关节疼痛和功能障碍,无深静脉血栓和伤口感染等并发症,无骨折畸形愈合,未遗留髋内翻畸形。结论 PFNA治疗股骨转子间骨折手术耗时少,术中X线透视时间短,创伤小,骨量丢失少;术后内固定稳定性强,并发症少,骨折愈合快,功能恢复快,疗效满意。

Objective To discuss the curative effect of proximal femoral nail anti-rotation（PFNA） in treating intertro-chanteric fracture. Methods 30 senile patients with femoral intertrochanteric fracture were treated by PFNA internal fixation. Various data, such as operation time, blood loss were recorded for evaluating the characteristics and curative effect. According to Harris scoring system, all cases got hip function scores. Results The duration of operation and intraoperative X-ray fluoroscopy was 35 -75 （60 ± 15 ）min and 0. 1 - 0. 3 （0. 20 ± 0. 10） min, respectively. The blood loss was 120 - 180 （150 ± 30） ml. All cases were followed up for 6 -18 months. The union was got in all cases, none of the complications occurred postoperatively, including nonunion, deep venous thrombosis or infection of the incision, malunion,and coxa vara. Conclusions Using PFNA to treat intertrochanteric fracture can obtain satisfying outcomes of different concerns, such as time-saving, small incision, few complications, quick recovery and so on.