PFNA治疗老年股骨粗隆间骨折临床疗效分析

Clinical curative effect analysis of PFNA in treatment of elderly patients with intertrochanteric fracture

目的：探讨PFNA治疗老年股骨粗隆间骨折的临床疗效。方法：回顾性分析2011年8月-2013年8月应用PFNA治疗的68例老年股骨粗隆间骨折患者资料，其中男32例，女36例。骨折按Evans～Jensen分类，I型21例，Ⅱ型26例，Ⅲ型15例，Ⅳ型6例。记录手术时间和术中出血量。采用Harris评分对其治疗效果进行评定。结果：68例患者均顺利通过手术，手术时间35～76分钟，术中出血量约50～180ml。术后所有患者均获随访，随访时间为6～30个月，平均16个月。按Harris标准进行评分：优36例，良26例，可4例，差2例；优良率91．18％。结论：应用PFNA内固定治疗老年股骨粗隆间骨折，手术创伤小、内固定牢靠、骨折愈合快、并发症少，是一种理想的手术方式，值得在临床上推广使用。

To explore the clinical efficacy of PFNA in the treatment of the elderly patients with intertrochanteric frac- ture. Methods ： Totally 68 elderly patients（ males 32 and females 36 ） with intertrochanteric fractures treated by the PFNA were retro- spectively analyzed from August,2011 to August, 2013. According to the Evans -Jensen classification of intertrochanteric fractures, there were 21 cases in type I ,26 cases in type Ⅱ , 15 cases in typeⅢ and 6 cases in typelV. Recording the operation time and the bleeding volume. Its outcome was evaluated by Harris scoring system. Results： Successful operation was achieved in 68 patients. The operation time was 35 ～76 minutes, the intraoperative blood loss was about 50 ～ 180ml. All patients were followed up for 6 to 30 months, averaging 16 months. According to Harris evaluation, 36 cases were rated as excellent, 26 good, 4 fair, and 2 poor. The excellent and good rate was 91. 18 %. Conclusion： The treatment of intertrochanteric fracture in elderly patients with PFNA should have advantages of less trauma, rigid fixation, fast bone healing, fewer complications, might be a ideal surgical approach, and worthy of clinical application.