股骨近端防旋髓内钉Ⅱ内固定治疗股骨转子间骨折的疗效观察

Clinical observation of proximal femoral anti-rotation nail internal fixation in the treatment of intertrochanteric fracture

目的评价股骨近端防旋髓内钉Ⅱ（PFNAⅡ）内固定治疗股骨转子间骨折的临床疗效。方法回顾性分析岳阳市岳化医院骨科2012年9月至2016年4月经PFNAⅡ内固定治疗的股骨转子间骨折患者37例的临床资料。结果37例患者手术顺利，手术时间范围40～120 min，平均66 min；出血量范围30～110 mL，平均50 mL；术中术后X线骨折对位良好，内固定牢靠。术后3 d患者行主动或被动活动患肢髋关节，术后7 d练习床上坐立，术后14 d拆线并下床扶拐不负重或部分负重行走。未出现下肢深静脉血栓（DVT）病例，术后多次复查显示骨折愈合良好，髋关节功能良好。结论PFNAⅡ是对PFNAⅠ型的改良，具有手术操作简单、创伤小、固定牢固及术后恢复迅速等优点，是治疗股骨转子间骨折的理想方法。

Objective To evaluate the clinical effect of proximal femoral nail anti-rotation Ⅱ（PFNA Ⅱ） internal fixation in the treatment of intertrochanteric fracture.Methods From September 2012 to April 2016, the clinical data of 37 patients with intertrochanteric fracture who were treated by PFNAⅡ internal fixation in Yuehua Hospital were retrospectively analyzed.Results All 37 patients were successfully operated, and the operation time was 40～120 min, with an average of 66 min.The amount of blood loss was 30～110 mL, with an average of 50 mL.During operation and after operation, X ray showed a good position and steady internal fixation.Three days after operation, patients exercised diseased side hip joint.Seven days after operation, patients exercised sitting on the bed.Fourteen days after operation, suture was dismantled and patients could get out of bed and walk with no weight or some weight.Lower limb deep venous thrombosis（DVT） was not observed.Through operative multiple reexamination, the fracture was healed and hip joint function was good.Conclusion PFNA Ⅱ has advantages of convenient operation, less trauma, stronger internal fixation, rapid recovery.It is an ideal method to treat intertrochanteric fracture.