PFNA-Ⅱ治疗老年人股骨转子间骨折的临床疗效分析

Clinical analysis of PFNA-Ⅱ in treatment of elder femoral intertrochanteric fracture

目的研究创新型股骨近端带锁防螺旋髓内钉(Proximal Femoral Nail Anti-rotation-Ⅱ,PFNA-Ⅱ)术式治疗老年股骨转子间骨折的临床疗效分析。方法选取2009年4月—2011年10月定兴县医院收治的35例采用PFNA-Ⅱ治疗股骨转子间骨折患者的临床资料进行回顾性分析,并对PFNA-Ⅱ临床治疗疗效进行综合评价。结果手术平均时间为(51.1±12..31)min,术中出血(71.9±21.78)ml。患者平均住院时间为(18.7±4.51)d,术后平均随访时间为(12.1±3.12)d。骨折愈合时间均在2～4个月,平均愈合时间(3.3±0.41)月,完全负重时间6～8个月,平均(6.8±1.12)个月。术后无明显并发症。依据Harris评分标准评定,28例优,4例良,2例可,1例差,优良率为91.4%。结论 PFNA-Ⅱ法具有操作简单、稳定固定、骨折愈合良好及无明显并发症等优点,是治疗中国老年人群股骨转子间骨折较好的方法,值得在临床治疗中推广。

Objective To study the effects of proximal femoral nail anti - rotation - Ⅱ （ PFNA -Ⅱ） in treating femoral intertroehanteric fracture in aged patients. Methods Retrospective analysis of clinical data of 35 cases of intertroehan-teric fractures collected from April 2009 to October 2011 admitted to our hospital with PFNA - Ⅱ for treatment, and com-prehensive evaluation on the therapeutic effects of PFNA - Ⅱ. Results Average operation time was （51.1± 12. 31 ） minutes, intraoperative hemorrhage was （71.9 ±21.78） ml. Average time of hospitalization was （ 18.7 ±4. 51 ）. Post-operative average follow-up time was （12. 1 ±3.12）. Fracture healing time was 2 -4 months, and the average time was （3.3 ±0. 41 ） months, full weight - bearing was 6 - 8 months, average was （6. 8 ± 1.12） months. No significant complications were found after surgery. Harris ratings criteria： good in 28 cases, well in 4 eases, general in 2 cases, bad in 1 case, excellent rate was 91.4%. Conclusions PFNA - Ⅱ is a simple operation, stable fixed, heal good and no obvious fracture healing complications, and other advantages, and is a better treatment of intertrochanteric fracture of femur in aged population, and worth to be publicized.