股骨近端防旋髓内钉固定治疗老年不稳定性股骨转子间骨折

Treatment of unstable intertrochanteric fractures with proximal femoral nail antirotation

目的探讨股骨近端防旋髓内钉(PFN-A)内固定治疗老年不稳定性股骨转子间骨折的临床效果。方法 91例不稳定性股骨转子间骨折患者在X线透视下行PFN-A内固定术。结果患者切口均一期愈合。91例均获得随访,时间8～24个月,骨折均愈合。按Harris髋关节评分标准:优67例,良16例,中6例,差2例,优良率为91.7%。1例术后1周出现肺动脉的不全性栓塞;1例术后3周猝死;2例术后8个月发现防旋刀片向后退出。结论 PFN-A内固定术治疗老年不稳定性股骨转子间骨折创伤小,术后可早期活动,临床疗效满意。

Objective To study the clinical effects of the treatment of unstable intertrochanteric fractures with proxi- mal femoral nail antirotation （PFN-A）. Methods 91 cases of ustable intertrochanteric fractures were treated with PFN-A under X-ray. Results All cases were followed up for 8 - 24 months. All cases＇ cuts were primary healing. According to Harris hip rate scale system, the results were excellent in 67 cases, good in 16, fair in 6, and poor in 2 and the excellent and good rate was 91.7%. 1 case occurred pulmonary thromboembolism after 1 week of the opera- tion and was cured after treatment. 1 case happened sudden death after the operation without any obvious causes. 2 cases were found anti-rotation screws loosening after 8 months of the operation without any symptoms. Conclusions It is an effective and safe way to treat unstable intertrochanteric fractures with proximal femoral nail antirotation, which has the advantages of less invasive, more stability and excellent clinical outcome.