PFNA治疗股骨粗隆间骨折分析

The analysis of proximal femoral nail antirotation in the treatment of intertrochanteric femur fractures

目的探讨pFNA在治疗股骨粗隆间骨折中的临床疗效。方法 2010年2月至2012年5月对42例股骨粗隆间骨折采用闭合复位PFNA内固定治疗。按Evans分型:Ib型21例,Ic型8例,Id型7例,Ⅱ型6例。术后无需外固定。结果所有患者均安全完成手术,随访5-24个月,平均18.5个月;骨折端均显现有明显骨痂形成,无内固定物失败。临床结果按Sanders评估标准,优34例,良6例,可1例,差1例,优良率95.2%。结论 PFNA具有操作简便、符合生物学固定原则、固定可靠、创伤小、骨量丢失少、并发症少,尤其适合老年患者等优点,是治疗股骨粗隆间骨折的理想方法之一。

Objective To investigate the clinical efficacy of proximal femoral nail antirotation （PFNA） in the treatment of intertrochanteric femur fractures. Methods From February 2010 to May 2012, 42 patients with intertrochanteric femur fractures underwent closed reduction and internal fixation with PFNA. According to Evans classification, there were 21 cases of type I b, 8 cases of type I c, 7 cases of type I d, and 6 cases of type II. External fixation was not needed after surgery. Results All surgeries were completed safely. All patients were followed up for a mean period of 18.5 months （range; 5-24 months）. Obvious bone callus formation appeared in all fractures, without internal fixation failure. According to Sanders post-trauma function assessment, the results were 34 excellent cases, 6 good, 1 fair and 1 poor. The excellent and good rate was 95.2%. Conclusions PFNA is one of the effective methods in the treatment of intertrochanteric femur fractures, with the advantages of simple operation, conforming to the biomechanical principles of internal fixation, solid fixation, less trauma, minimum loss of bone and less compilations, especially suitable for senile patients.