闭合复位防旋型股骨近端髓内钉内固定治疗老年股骨转子间骨折

Treatment of femoral intertrochanteric fractures in elderly patients with closed reduction and internal fixation by using proximal femoral nail antirotation

目的：探讨防旋型股骨近端髓内钉（ PFNA）闭合复位内固定治疗老年股骨转子间骨折的疗效。方法对45例老年股骨转子间骨折患者采用闭合复位、小切口置入PFNA治疗,根据Harris评分评价治疗效果。结果手术时间45~90 min,术中出血量100~200 ml。患者均获得随访,时间8~17个月。骨折均骨性愈合。无螺旋刀片切割或退出。髋关节功能Harris评分：优36例,良7例,可2例,优良率为95．6%。结论 PFNA闭合复位内固定治疗老年股骨转子间骨折创伤小,操作简便,手术时间短,出血少,愈合率高。

Objective To investigate the clinical effects of femoral intertrochanteric fracture in elderly patients treated with closed reduction, small incision and internal fixation by using proximal femoral nail antirotation（ PFNA） . Meth-ods 45 patients with femoral intertrochanteric fractures were treated with closed reduction and internal fixation by u-sing PFNA. Functional outcomes were assessed according to the Harris hip scoring system. Results The operation time was 45~90 min, the blood loss was 100 ~200ml. All the patients received a follow-up from 8 months to 17 months. Bone union was achieved in all cases. There was no helical blade cutting-out. Harris hip function was excel-lent in 36 cases, good in 7, fair in 2, the excellent-good rate was 95. 6%. Conclusions It is effective with PFNA to treat femoral intertrochanteric fractures in elderly patients, because the procedure is less invasive and convenient, with short operation time, less blood loss, and high union rate.