股骨近端抗旋髓内钉治疗股骨粗隆间骨折合并股骨颈基底部骨折

Proximal femoral nail antirotation in the treatment of femoral intertrochanteric fractures accompanied with basal fractures of ipsilateral femoral neck

目的 探讨股骨近端抗旋髓内钉治疗股骨粗隆间合并同侧股骨颈基底部骨折的临床疗效。方法2008年7月-2013年3月该院收治了21例股骨粗隆间骨折合并同侧股骨颈基底部骨折的患者,其中12例行股骨近端抗旋髓内钉固定（PFNA组）,9例选用股骨近端解剖锁定钢板固定（钢板组）,回顾性分析两组临床资料和疗效。所有病例随访12∽24个月,平均18个月。结果 钢板手术组有2例出现伤口感染,换药后愈合,1例出现螺钉切割致髋内翻畸形愈合。PFNA组的手术时间、术中出血量、切口长度、术后1个月Harris评分、骨折愈合时间明显优于钢板组。结论 股骨近端抗旋髓内钉治疗是一种治疗股骨粗隆间合并同侧股骨颈基底部骨折可靠和满意的手术方法。

[ Objective ] To explore the clinical efficacy of PFNA in the treatment of femoral intertrochanteric fractures accompanied with basal fractures of ipsilateral femoral neck. [Method] From July 2008 to March 2013, Group PFNA （12 cases） were treated with PFNA and group C （9 cases） were treated with anatomical proximal femoral locking plate, all cases were followed up for 12-24 months, average 18 months. [Result] In group C, the infection of wound occurred in 2 patients and the malunion of coxa vara resulting from screw cut-out occulted in a patient. There are significant differences between two groups in operation time, intraoperative blood loss, incision lengths, the Harris hip joint score and the union time of fractures. The indicators for group PFNA were better than those for group C. [ Conclusion ] The proximal femoral nail antirotation is a reliable and effective method to treat femoral in- tertrochantefic fractures accompanied with basal fractures of ipsilateral femoral neck.