PFNA-Ⅱ治疗老年股骨转子间骨折40例分析

The Analysis of PFNA- Ⅱ in the Treatment of Senile Intertrochanteric Fracture for 40 Cases

目的:观察亚洲型股骨近端抗旋髓内钉治疗老年股骨转子间骨折的临床疗效和安全性。方法:采用亚洲型股骨近端抗旋髓内钉治疗老年股骨转子间骨折患者40例,男18例,女22例。年龄65～80岁,平均75.5岁。均为单侧闭合性顺转子间骨折。按Evans分型,Ⅰ型3例,Ⅱ型7例,Ⅲ型13例,Ⅳ型17例。受伤至手术时间2～8d,平均4d。合并糖尿病10例,骨质疏松症32例,冠心病10例,高血压病12例。结果:本组患者手术时间(65.81±10.34)min,术中出血量(130.81±45.02)ml,住院时间(11.33±2.77)d。本组2例患者输血100ml,2例患者输血200ml,其余患者均未输血。骨折愈合时间7～14周,平均10周。末次随访时Harris评分80～95分,平均85.4分。5例患者行走时患肢有隐痛,但不影响日常生活。2例患者发生肺部感染,对症处理后痊愈。未发生股骨头颈缩短、股骨头颈切割、髋内翻及内固定失效等并发症。结论:PFNA-Ⅱ是治疗老年股骨转子间骨折的一种安全有效的方法,更加符合亚洲人的骨骼解剖特点,值得临床推广应用。

Objective： To observe the clinical efficacy and safety of proximal femoral nail antirotation- II in the treatment of elderly intertrochanteric fracture.Methods： 40 patients of senile intertrochanteric fractures treated with the PFNA- II, 18 males and 22 females.Age 65 to 80 years old, with an average of 75.5 years.The patients all were unilateral blunt cis intertrochanteric fracture.The Evans classification type I 3 cases, type II 7 cases, 13 eases of type III, IV 17 cases.Injury to operation 2-8 d, with an average of 4 d.The complications of diabetes was 10 cases, osteoporosis was 32 cases, 10 cases of coronary heart disease, 12 cases of hypertension.Results： The mean operative time was （65.81 ± 10.34）min, blood loss （130.81 ± 45.02） ml, hospitalization time （11.33 ± 2.77）d.The group 2 patients transfusion of 100 ml of blood transfusion in 2 patients, 200 ml, and the remaining patients without blood transfusion.Fracture healing time of 7 to 14 weeks, an average of 10 weeks.Harris score 80 to 95 points the last follow-up, an average of 85.4 points.5 patients walking limb pain, but didn＇ t affect their daily lives.Two patients developed pulmonary infection, symptomatic treatment cured. Femoral head and neck did not occur shortened femoral neck cut, varus and internal fixation failure and other complications.Conclusion： PFNA- I] is a safe and effective method for the treatment of senile intertrochanteric fracture, more in line with the the Asian bone anatomical characteristics, it worthy of clinical application.