股骨近端防旋髓内钉联合中药三期辨证治疗高龄股骨粗隆骨折

Treating elderly patients of femoral trochanter fracture with proximal femoral nail antirotation combined with three period syndrome differentiation of Chinese medicine

目的:探讨股骨近端防旋髓内钉(PFNA)联合中药三期辨证治疗高龄股骨粗隆骨折相关问题。方法:32例高龄股骨粗隆骨折病例,采用闭合复位顺行置钉技术。术后常规抗凝治疗,中药三期辨证,渐进康复锻炼。结果:本组32例患者,手术时间平均为40min,术中出血平均为80mL。32例患者均得到随访,平均随访时间12个月,无一例死亡,全部病例临床或骨性骨折愈合,愈合时间平均为3.2个月。所有病例均能独立行走,1例轻度髋内翻,2例轻度大腿前侧间隙性疼痛。参照Harris髋关节功能评分标准,优19例,良11例,可2例,优良率94%。结论:PFNA是治疗高龄股骨粗隆骨折的有效方法之一,重视三期辨证用药提高术后机体损伤耐受,缩短机体康复周期,有效复位相对稳定与早期功能锻炼相统一是提高治疗成功率的重要环节。

Objective： To analyze the related problems of treating elderly patients of femoral trochanter fracture with proximal femoral nail anti-rotation（PFNA） combined with three period syndrome differentiation of Chinese medicine.Methods： 32 elderly patients of femoral trochanter fracture were treated with closed reduction and anterograde nailing techniques.Conventional anticoagulant therapy,three period syndrome differentiation of Chinese medicine and rehabilitation exercise were carried out after operation.Results： The mean operating times of 32 patients were 40 min,and mean bleeding amount was 80mL.The average follow-up times of 32 patients were 12 months,and all fractures healed with no deaths,and the average healing times were 3.2 months.All the patients could walk independently and 1 case with mild hip varus and 2 cases with mild clearance pain in the front of the thigh.There were 19 patients could be rated as excellent and 11 patients could be rated as good according to Harris scoring criteria,and the excellent and good rate was 94%.Conclusion： PFNA is one of the effective methods for treatment of elderly patients of femoral trochanter fracture,and paying attention to period syndrome differentiation of Chinese medicine could enhance the body endurance ability of damage after operation and shorten the body rehabilitation period.Unity of effective reduction and early function rehabilitation is an important part for success rate improving.