侧卧位PFNA治疗股骨粗隆间骨折疗效分析

Efficacy analysis of PFNA in lateral position for the treatment of intertrochanteric fracture of femur

目的探讨侧卧位股骨近端防旋髓内钉(PFNA)治疗股骨粗隆间骨折的疗效.方法回顾性分析2011年2月~2019年3月本院收治的423例采用侧卧位PFNA治疗的股骨粗隆间骨折患者的临床资料.统计分析423例患者的手术时间、术中出血量,术后随访6~12个月,观察患者骨折愈合情况、术后并发症发生情况,术后6个月采用Harris髋关节功能评分标准评定患者的治疗效果.结果420例患者采用侧卧位非牵引床闭合复位,手术时间为15~30 min,3例患者采用侧卧位牵引床闭合复位,手术时间为50~70 min;平均术中出血量为50 ml;术后随访6~12个月,所有患者骨折均愈合,术后无内固定物移位及松动、骨延迟愈合、骨不连等并发症发生.术后6个月根据Harris髋关节功能评分标准评价患者的治疗效果,其中优383例,良38例,可1例(发生感染),差1例(均因内科疾病加重而死亡),优良率为99.5%(421/423).结论侧卧位PFNA治疗股骨粗隆间骨折固定牢靠,术中出血量少,操作简便.

Objective To discuss the efficacy of proximal femoral nail anti-rotation(PFNA)in lateral position for the treatment of intertrochanteric fracture of femur.Methods The clinical data of 423 cases of intertrochanteric fracture of femur treated with PFNA in lateral position from February 2011 to March 2019 were analyzed retrospectively.The operation time and intraoperative bleeding volume of 423 patients were analyzed.The patients were followed up for 6-12 months,and the fracture healing and occurrence of postoperative complications was observed.Harris hip function score was used to evaluate the treatment effect of the patients at 6 months after operation.Results 420 patients were treated with closed reduction of non-traction bed in lateral position,the operation time was 15-30 minutes,and 3 patients were treated with closed reduction of traction bed in lateral position,with operation time as 50-70 min and average intraoperative bleeding volume as 50 ml.After 6-12 months follow-up,all the fractures healed,and there were no complications such as internal fixation displacement and loosening,delayed healing and nonunion.Harris hip joint function score was used to evaluate the treatment effect of the patients at 6 months after operation,including 383 excellent cases,38 good cases,1 fair case(infection),1 poor case(death due to aggravation of internal diseases),the excellent-good rate was 99.5%(421/423).Conclusion The treatment of intertrochanteric fracture of femur with PFNA in lateral position is reliable and easy to operate with less amount of intraoperative hemorrhage.