股骨近端防旋髓内钉治疗老年股骨转子间骨折

Effect of PFNA in Treatment of Elderly Intertrochanteric Fractures and Perioperative Management

目的:探讨股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折的疗效及围手术期的处理。方法:回顾性分析获得完整随访的采用PFNA固定的50例老年股骨转子间骨折患者资料,随访11~22个月,平均(16.3±4.2)个月。分析其手术时间、术中出血量、骨折愈合时间、髋内翻畸形发生率和末次随访髋关节评分,探讨围手术期的处理。结果:手术时间平均(80.6±13.7)min,术中出血量平均(70.8±20.6)mL,骨折愈合时间平均(4.5±0.7)个月,术后髋内翻畸形发生率2%(1/50),末次随访髋关节评分平均(91.8±3.6)分。结论:PFNA内固定术是治疗老年股骨转子间骨折的有效术式,应加强围手术期的处理,提高手术疗效。

Objective To investigate the effect of proximal femoral nail antirotation(PFNA)for elderly intertrochanteric fractures and the perioperative management.Methods A retrospective study was conducted to analyze the clinical data of elderly intertrochanteric fractures cases which were treated with PFNA fixation from June 2015 to June 2017 in the department of orthopaedics of People's Hospital.In the study,50 cases were followed up completely.The operation time,amount of bleeding,fracture healing time,the incidence of varus hip deformity,the last follow-up of hip function scores were analyzed and the perioperative management were discussed.Results The patients were followed up for 11 to 22 months,with an average of(16.3±4.2)months.The operation time was(80.6±13.7)min,the amount of bleeding was(70.8±20.6)mL,the fracture healing time was(4.5±0.7)months,the incidence of varus hip deformity was 2%(1/50)and the postoperative hip score was(91.8±3.6).Conclusion The PFNA is a useful tool in the treatment of elderly intertrochanteric fractures,and also we should strengthen perioperative management to improve operative outcomes.