徒手牵引复位股骨近端防旋髓内钉治疗股骨转子间骨折

Treatment of intertrochanteric fractures with manual traction reduction and proximal femoral nail antirotation

目的探讨徒手牵引复位股骨近端防旋髓内钉(PFNA)固定股骨转子间骨折的手术技巧及可行性。方法采用徒手牵引复位PFNA固定治疗37例股骨转子间骨折患者。术后3 d采用Baumgaertner改良法评价骨折复位质量,术后1年采用Harris评分评估髋关节功能。结果手术时间40～100 min,术中失血量100～300 ml。术后3 d骨折复位质量评价:优21例,良14例,差2例。29例患者获得随访,时间15～36个月。术后1年髋关节功能评价:优9例,良13例,可4例,差3例,优良率22/29。结论徒手牵引复位PFNA固定股骨转子间骨折在掌握手术技巧的前提下具有可行性。

Objective To investigate the operation skills and feasibility of proximal femoral nail antirotation(PFNA) with the manual traction reduction in the treatment of femoral intertrochanteric fractures. Methods The 37 cases with femoral intertrochanteric fractures were treated with manual traction reduction and PFNA fixation. The quality of the fractures reduction was evaluated according to the modified Baumgaertner evaluation system at 3 d postoperation. The hip joint function recovery of patient was evaluated by using Harris scoring system at 1 year postoperation. Results The operation time was 40~100 min, blood loss was 100~300 ml. The postoperative quality of fracture reduction was excellent in 21 cases, good 14 cases and poor 2 cases at 3 d postoperation. The 29 cases were followed up for 15~36 months.The hip joint Harris score at 1 year postoperation was excellent in 9 cases, good 13 cases, fair 4 and poor 3, the excellent and good rate was 22/29. Conclusions With good operation skills, femoral intertrochanteric fractures can be treated successfully by manual traction reduction and PFNA.