PFNA-Ⅱ治疗老年股骨转子间不稳定骨折

PFNA-Ⅱ in the Treatment of Unstable Intertrochanteric Fractures in the Elder

目的:探讨应用亚洲型股骨近端防旋髓内钉(PFNA-Ⅱ)治疗老年股骨转子间不稳定骨折疗效果。方法:选取笔者所在医院2013年1月-2015年12月收治的109例老年股骨转子间不稳定骨折患者,获得随访97例,男36例,女61例。骨密度-1.5^-4.5,;改良Evans分型,Ⅱ型27例,Ⅲ型38例,Ⅳ型24例,Ⅴ型8例。选用PFNA-Ⅱ固定。结果:平均手术时间(45±15)min,术中平均出血(110±50)ml,随访时间6~30个月,全部骨性愈合,愈合时间4~8个月。术后半年髋关节功能根据Harris评分评定为(95.7±3.7)分;根据髋关节相关评定标准评定,优74例,良15例,中5例,差3例,优良率91.7%。术后钉头骨质切割1例,轻度髋内翻畸形愈合2例,无其他并发症出现。结论:PFNA-Ⅱ适用于不稳定型亚洲老年股骨转子间骨质疏松性骨折,创伤小,疗效满意。

Objective： To investigate the efficacy of the treatment of unstable intertrochanteric fractures in elderly patients with the treatment of proximal femoral proximal femoral nail antirotation Ⅱ（PFNA-Ⅱ）.nethod： In our hospital, from January 2013 to December 2015, 109 elderly patients with unstable intertrochanteric fractures were treated.97 cases were followed up, 36 cases were male and 61 cases were female.Bone density -1.5 to -4.5 ; modified Evans classification, typeⅡwas 27 cases, type IR was 38 cases, type Ⅳ was 24 cases, type V was 8 cases.Asian proximal femoral nail antirotation Ⅱ（PFNA-Ⅱ） fixation was chosen.Result： The average operation time was （45 ±15）min, the average bleeding was （110 ± 50）ml, the follow-up time was 6-30 months, all healed, and the healing time was 4-8 months.6 months after operation,, the evaluated score of the hip function was （95.7 ± 3.7） according to the Harris score; according to hip joint evaluation criteria, excellent in 74 cases, good in 15 cases, medium in 5 cases, poor in 3 cases, excellent and good rate was 91.7%.There were 1 case of nail head bone cutting, 2 cases of mild hip deformity, and no other compiications.Conelusion： PFNA-Ⅱ is suitable for the unstable intertrochanteric osteoporotie fracture in Asian, with little trauma and satisfactory curative effect.