防旋股骨近端髓内钉治疗外侧壁不完整性股骨转子间骨折的效果观察

Effect of the treatment of proximal femoral nail antirotation in pertrochanteric hip fractures with unstable lateral-wall

目的探讨防旋股骨近端髓内钉（PFNA）治疗外侧壁不完整性股骨转子间骨折的临床效果。方法2010年4月至2012年5月使用PFNA治疗32例外侧壁不完整性股骨转子间骨折。记录每例患者的手术时间、术中出血量、并发症等数据，对该治疗方法进行初步评价。并分别于术后6周、3个月、6个月、12个月安排复诊，检查患肢功能并常规摄患髋正、侧位x线片。术后髋关节功能评定使用Harris评分。测量最后一次随访时的颈干角并与术后比较。结果本组病例手术时间为60～190min，平均（80±5）min；术中出血量为90～250ml，平均（120±9）ml；平均住院天数（15±7）d；负重时间为术后（6．3±1．2）周，骨折愈合时间平均3．6个月。所有患者均获骨折愈合，无髋内翻或内固定切出等并发症发生。结论PFNA具有固定可靠、创伤小、并发症少和功能恢复好等特点，是治疗外侧壁不完整性股骨转子间骨折较理想的方法。

Objective To investigate the treatment of proximal femoral nail antirotation （PFNA） in pertroehanteric hip fractures with unstable lateral-wall. Methods Thirty-two cases were included from the April 2009 to May 2011. Recorded operation period, blood loss volume, and complications and evaluated the effect of the methods. Arrange referral at 6 weeks,3 months,6 months, 12 months respectively after operation, to check limb function and conventional camera hips, lateral X-ray film. Postoperative functional evaluation using the Harris hip score. Measure the last follow-up neck shaft angle and compare with postoperative＇s. Results The average operation period was （ 60 - 190 ） rain, average was （ 80 ＋ 5 ） min ; blood loss volume was （ 90 - 250 ） ml, average was （ 120 ~ 9 ） ml; Average hospital periods was （ 15 ＋ 7 ） days ; weight loading time was （ 6. 3 ~ 1.2 ） weeks after surgery and average time of union of fracture was 3.6 months. All patients obtained union of fracture without complications such as varns, internal fixation cutting out. Conclusion PFNA was proved to be an effective way for treating unstable lateral-wall of pertrochanteric hip fractures due to its advantages of stable fixation, minor trauma,less complications .