无牵引床半截石位PFNA手术治疗股骨粗隆间骨折临床评价

Treatment of intertrochanteric fractures with PFNA in half lithotomy position without traction bed

目的评价无牵引床半截石位股骨近端防旋髓内钉(PFNA)手术治疗股骨粗隆间骨折的临床疗效。方法选择我院2012年—2016年间收治的45例股骨粗隆间骨折患者,全部采用无牵引床半截石位PFNA内固定,对疗效进行分析评价。结果 45名患者均获得随访,随访时间10个月～36个月,平均18.8个月,手术用时最长98 min,最短40 min,平均55.6 min,手术切口均Ⅰ期愈合,住院期间无严重并发症。根据末次复查X线结果,骨折均愈合,无内固定断裂。1例患者出现髋内翻,长时间行走后患肢出现疼痛不适。根据Harris髋关节评分标准:优28例,良12例,中4例,差1例,优良率88.9%。结论无牵引床半截石位PFNA治疗股骨粗隆间骨折,具有术中操作简便,体位变化灵活,手术耗时短,透视方便等优点,基层医院也可顺利进行,值得推广。

Objective To analyze the clinical effect of PFNA in treatment of intertrochanteric fractures in half lithotomy position without traction bed.Methods Forty-five cases of intertrochanteric fractures treated in the author's hospital between2012and2016were studied.All these cases treated with PFNA in half lithotomy position without traction bed.The postoperative Harris scores of the hip were observed.Results All the 45 patients were followed up from 10 to 36 months,average 18.8 months.The longest operation was 98 minutes,and the shortest 40 minutes,55.6 minutes on average.No infection of surgical incision and no serious complications during hospitalization.X-Ray was reexamined after operation and all the patients were bony union,no internal fixation breakage according to the last time followed up.There were1patient of coxa vara with hip pain after long walk.According to the Harris scores of the hip,excellent in 28 cases,good in 12 cases,medium in 4 cases,fair in1cases,the excellent-good rate was 88.9%.Conclusions PFNA in half lithotomy position without traction bed is effective in the treatment of intertrochanteric fractures.It is easy to operate,flexible in position,short in operation time and convenient in perspective.Grass-roots hospitals can also successfully perform such operations without traction beds.This treatment is worthy of clinical promotion.