闭合复位股骨近端防旋髓内钉微创治疗高龄股骨转子间骨折

Closed reduction and minimally invasive with proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures in the elderly patients

目的探讨应用闭合复位股骨近端防旋髓内钉(PFNA)微创内固定治疗高龄股骨转子间骨折的临床疗效。方法采用牵引床牵引、闭合复位PFNA微创内固定术治疗63例高龄股骨转子间骨折患者。结果术前住院时间0.5~7 d;手术时间35~90 min;术中出血量30~150 ml。骨折愈合时间10~24周。患者均获得随访,时间6~22个月。无髋内翻畸形、螺旋刀片切割或退出、感染等并发症发生。末次随访根据髋关节Harris功能评分评定:优49例,良11例,可3例,优良率为95.2%。结论闭合复位PFNA微创内固定治疗高龄股骨转子间骨折具有术前住院时间短、创伤小、出血少、固定可靠、骨折愈合率高等优点。

Objective To investigate the clinical effect of closed reduction and minimally invasive internal fixation with proximal femoral nail（ PFNA） in the treatment of intertrochanteric fractures in the elderly. Methods The 63 cases of intertrochanteric fractures were treated with PFNA minimally invasive internal fixation after closed reduction with traction. Results Preoperative hospitalization time was 0. 5- 7 d. The operation time was 35- 90 min. The volume of bleeding during the operation was 30 - 150 ml. Fracture healing time ranged from 10 weeks to 24 weeks.All patients were followed up for 6 - 22 months. No hip deformity,spiral blade cutting or withdrawal,infection and other complications occurred. According to the Harris hip function evaluation standard. At last follow-up,the hip function was excellent in 49 cases,good in 11,fair in 3,and the excellent and good rate was 95. 2%. Conclusions Closed reduction and minimally invasive with PFNA for treatment of intertrochanteric fractures in the elderly patients,which has advantages such as short preoperative hospital stay,less trauma,less bleeding,reliable fixation,high fracture healing rate.