股骨近端防旋刀片髓内钉(PFNA)治疗老年股骨转子间骨折的临床研究

Clinical Study on the Effect of Proximal Femoral Nail Antirotation (PFNA) in the Treatment of Intertrochanteric Fracture in the Elderly Patients

目的深入分析和研究股骨近端防旋刀片髓内钉(PFNA)技术在治疗老年股骨转子间骨折的临床应用,提高老年股骨转子间骨折疾病治疗质量。方法收集收集2009年3月至2012年5月期间来我院采取股骨近端防旋刀片髓内钉手段治疗股骨转子间骨折的老年病患47例。均采用完善的手术治疗方法,主要包括手术之前的准备、手术过程中的方法和手术之后的治疗,对股骨近端防旋刀片髓内钉进行分析。结果 47例病患手术时间为45～80min,平均时间为55min,手术过程当中出血为48～245mL,平均出血量为90mL。47例病患当中有40例病患随访11个月,平均随访时间为5.5个月,没有死亡出现。X线片结果显示骨折一期都有效愈合,没有出现伤口感染、内固定松动、骨不连和断裂等现象的发生。治疗效果优22例、良14例、可4例,优良率为90.0%。结论股骨近端防旋刀片髓内钉(PFNA)技术在治疗老年股骨转子间骨折的过程中成功率较高,出血量小,风险较少,能够有效地提高老年股骨转子间骨折的治疗质量,值得广泛的推广运用。

Objective To analyze the effect of proximal femoral nail antirotation （PFNA） in the treatment of intertrochanteric fracture in the elderly patients. Methods 47 cases of elderly intertrochanteric fracture treated with PFNA in our hospital from March 2009 to May 2012 were selected and analyzed in this study. The perfect treating methods including preparation before operation and care after the treatment were taken. Proximal femoral nail anti-rotation was analyzed. Results The operation time was 45 - 80 min, the average time was 55 min; hemorrhage in operation process was 48 - 245 mL, average bleeding volume was 90 mL; 40 patients were followed up for 11 months, and no deaths were observed. Radiographs showed that no wound infection, nonunion, internal fixation loosening and breaking phenomenon occurred. 22 cases of treatment effect were excellent, and 14 cases were good. The excellent and good rate was 90.0%. Conclusions PFNA is a good method in the treatment of intertrochanteric fracture in elderly patients due to its characteristics of higher success rate, less bleeding, less risk, which can effectively improve the treatment quality and be worthy of wide application.