老年骨质疏松性股骨转子间骨折PFNA-2手术疗效

Key surgery technical points for Osteoporotic intertrochanteric fracture of femur with PFNA-2

目的:探讨股骨近端抗旋髓内钉(PFNA-Ⅱ)内固定治疗老年骨质疏松性股骨转子间骨折手术过程中的关键要点.方法:采用回顾性病例系列研究分析2015年1月-2018年6月收治的51例老年骨质疏松性股骨转子间骨折患者资料,男15例,女36例;年龄为60-91岁,平均71.8岁;骨折AO分型:稳定型(A1.1型至A2.1型)17例,不稳定型(A2.2型至A3.3型)34例.采用股骨近端防旋髓内钉(PFNA-Ⅱ)固定治疗,记录患者骨折愈合时间、内固定失败例数及末次随访时髋关节Harris评分.结果:患者术后均获随访,平均28个月(3-42个月),骨折均愈合,平均时间12周,未出现锁钉的误锁,未出现内固定断裂,未出现骨折愈合延迟.末次随访时髋关节Harris评分为57-92分,平均为81.6分;优19例,良26例,可6例,优良率为84%.结论:PF-NA-2是治疗老年骨质疏松性股骨转子间骨折的可靠治疗方法.

Objective:To investigate the treatment of intertrochanteric fracture of femur in elderly patients with proximal femoral anti rotation intramedullary nail.Methods:A retrospective analysis from January 2015 to June 2018 with proximal femoral nail anti rotation data of 51 cases of elderly patients with osteoporotic intertrochanteric fracture fixation,male 15 cases,female 36 cases;age ranged from 60 to 91 years old,average 71.8 years old;AO type fractures:stable type(type A1.1 to A2.1 type)17 cases,unstable type(A2.2 to A3.3)in 34 cases.The time of fracture healing,the rate of failure of internal fixation and the Harris score of the hip at the last follow-up were recorded.Results:51 patients were followed up for an average of 28 months(3-42 months).Of the 51 patients,fractures were healed,over average of 12 weeks,no had mislocked screws,no had internal fixation failure,and no had delayed union.At the last follow-up,the hip Harris score averaged 81.6 points(57~92 points).The results were excellent in 19 cases,good in 26 cases,fair in 6 cases,no poor,and the excellent and good rate was 84%.Conclusion:PFNA-2 was an effective method for the treatment of osteoporotic intertrochanteric fracture in the elderly.