PFNA内固定治疗老年骨质疏松性股骨粗隆间骨折的疗效分析

Clinical analysis of PFNA internal fixation invasive in the treatment of intertrochanteric fractures

目的探讨股骨近端防旋髓内钉(PFNA)内固定治疗老年骨质疏松性股骨粗隆间骨折的临床疗效。方法自2014年7月~2015年12月采用闭合复位PFNA内固定治疗老年骨质疏松性股骨粗隆间骨折42例。记录麻醉后牵引复位时间、手术时间、手术失血量、术后引流量,以及术中、术后并发症,末次随访采用髋关节功能Harris评分评定疗效。结果本组麻醉后牵引复位时间12~18(13.8±4.6)分钟,手术操作时间28~66(42.6±18.2)分钟,术中失血量150~550(271.6±115.5)mL,术后引流量80~240(150.8±90.7)mL,住院时间(15.5±2.5)天。所有42例患者均获得随访6~18个月,平均8.2个月,骨折愈合时间平均4.5个月。末次随访使用Harris评分标准评定疗效:优29例,良11例,可2例,优良率95.2%。结论闭合复位PFNA内固定治疗老年骨质疏松性股骨粗隆间骨折手术创伤小,操作简单,具有良好支撑,是一种效果确切的手术方法。

Objective To investigate the clinical effect of treatment of intertrochanteric fracture of femur （IFF） with proximal femoral nail （PFNA）. Methods Clinical data of 42 elderly osteoporotic patients with femoral intertrochanteric fractures from Jul 2014 to Dec 2015 were treated with proximal femoral nail （PFNA） in our hospital. Operative time, the blood loss, traction reset time, volume of drainage after surgery, intraoperative and postoperative complication and last Harris hip function score were recorded. Results All 42 patients were followed up with an average of 8.2 months （range, 6 to 18 months）. The average time of fracture healing is 4.5 months. The excellent rate was 95.2% for last Harris hip function scores. Conclusion PFNA internal fixation for femoral intertrochanteric fracture had good clinical efficacy. It is minimally invasive, good support, simplicity of operator for elderly osteoporotic patients, and it is safe.