PFNA治疗高龄外侧壁危险型股骨粗隆间骨折的疗效分析

Therapeutic Effect of Proximal Femoral Nail Antirotation(PFNA) in Old Interchanteric Femoral Fractures Patients with Lateral Wall Risk

目的通过24例外侧壁危险型高龄股骨粗隆间骨折患者的回顾及随访,评估防旋型股骨近端髓内钉(proximal femoral nail antirotation,PFNA)对其的疗效。方法选取我科于2009年1月至2010年11月,采用PFNA治疗的高龄(>70岁)外侧壁危险型股骨粗隆间骨折患者24例,术后8个月按Baumgaertner′s标准[2,3]评价复位质量,按Harris髋部评分系统评价患者的功能恢复情况。结果 24例患者术后均获得随访,随访时间8～13个月,平均9个月。所有患者均获得骨愈合。复位质量优17例,良3例,可3例,差1例,优良率83.3%;术后功能评分本组优18例,良3例,可0例,差3例,优良率为87.5%。结论对于高龄外侧壁危险型股骨粗隆间骨折患者,PFNA具有髓内固定的生物力学优势,骨折愈合率高,患者能早期下地负重和功能锻炼使得功能恢复佳,是治疗外侧壁危险型股骨粗隆间骨折非常有效和安全的方法。

Objective Our study was to evaluate the therapeutic effect using the proximal femoral nail antirotation（PFNA） for intertrochanteric femoral fractures in old patients with lateral wall risk.Methods Between Jan,2009 and Nov,2010,24 patients with lateral wall risked intertrochanteric femoral fractures were treated with PFNA.We use Baumgaertner′s criteria to evaluate the reduction of fracture.Functional consequence were assessed according to the Harris hip scoring system.Results A follow-up of 8～13 months were done in the 24 patients.All patient got bone union.Fracture reduction was very good in 17 patients,good in 3 Patients,acceptable in 3 patients and poor in 1 patient.Harris hip scores were very good in 18 patients,good in 3 patients,moderate in 0 patients,and poor in 3 patients.Conclusion According regarding to the old people intertrochanteric femoral fracture,PFNA osteosynthesis is a good method of surgical treatment of intertrochanteric femoral fractures especially in the case with lateral wall risk.