PFNA治疗老年股骨转子间骨折的临床疗效分析

Effect of PFNA Internal Fixation for Treatment of Elder Patients who Suffered from Comminute Intertrochanteric Fracture

目的探讨PFNA治疗老年股骨转子间骨折的方法和疗效。方法回顾性分析2013年6月至2015年2月应用PFNA内固定治疗老年股骨转子间骨折患者32例。男13例,女19例;年龄67~92,平均74.3岁;骨折按AO分型:A1型5例,A2型17例,A3型10例。采用Harris髋关节评分标准评价术后疗效。结果所有患者获得9~18个月(平均12个月)随访。骨折均一期愈合,愈合时间为12~24周,平均16周。无感染、髋内翻、内固定失效等并发症发生。术后髋关节Harris评分:优23例,良7例、可2例,优良率为93.75%。术前Harris髋关节评分为(46.3±5.4)分,术后Harris髋关节评分为(87.9±6.1)分,两者差异有统计学意义(P<0.05)。结论 PFNA内固定术符合生物学固定原则,具有创伤小,对骨折端血运影响小,并发症少等优点,是目前治疗老年股骨转子间骨折的良好选择。

Objective The study aims to clarify the therapeutic effect of the intertrochanteric hip frature in the aged patients. Methods 32 aged patients of the intertrochanteric hip frature were retrospectively studied from 2013. 6 to 2015. 2. 13 of them were male,and the other 19 cases were female. The average age was 74. 3 years old,ranging from 67 to 92 years old.There were 5 cases of A1 type,17 cases of A2 type and 10 cases of A3 type by the AO classification. The Harris score was used to evaluate the therapeutic effect. Results All patients were followed up 9 to 18 months.（ average 12 months） All fractures were primary healing,ranging from 12 to 24 weeks（ average 16weeks） with no complication. The satisfaction rate was93. 75% by the Harris score,with 23 very good cases,7 good cased and 2 acceptable cases. The preoperative Harris hip score was 46. 3 ± 5. 4,while the postoperative Harris hip score was 87. 9 ± 6. 1. There was no significant difference between these two goups（ P〈0. 05）. Conclusion The PFNA is a good choice to treat the intertrochanteric hip frature in the aged patients.