股骨近端防旋髓内钉治疗高龄股骨转子间骨折

Treatment of elderly intertrochanteric fractures with proximal femoral nail anti-rotation

目的探讨闭合复位股骨近端防旋髓内钉(PFNA)治疗高龄股骨转子间骨折的临床疗效。方法采用闭合复位PFNA内固定治疗31例高龄股骨转子间骨折患者。结果手术时间25~85 min,术中出血量70~160 ml。2例术后4周死于肺部严重感染,29例获得随访,时间7~23个月。患者骨折复位固定满意且均临床愈合。末次随访根据髋关节Harris功能评分评定:优8例,良14例,可7例。结论闭合复位PFNA内固定治疗高龄股骨转子间骨折具有创伤小、术中出血少、操作简单、手术时间短、固定可靠、早期功能锻炼的优点。

Objective To explore clinical effects of the proximal nail anti-rotaion（ PFNA） internal fixation in treatment of elderly patients with femoral intertrochanteric fractures. Methods Thirty-one cases of elderly intertrochanteric fractures were treated with PFNA internal fixation. Results The operative time was 25 - 85 min,the blood loss was 70 - 160 ml. Two cases died in 4 weeks after operation due to severe lung infection. The 29 cases were followed up for 7 - 23 months. They obtained good fixation and fracture healing. At the last follow-up,the result of clinical efficacy according to Harris hip scores showed： excellent in 8 cases,good in 14 cases,fair in 7 cases. Conclusions PFNA internal fixation in treatment of elderly patients with intertrochanteric fracture has the adavantage of less trauma,operating time and blooding,simple operation,stable fixation,allowing patients to do exercise early.