老年股骨粗隆间骨折PFNA内固定治疗体会

PFNA internal fixation in the treatment of intertrochanteric fracture in the elderly

目的:探讨股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折的疗效。方法:回顾分析医院骨科收治的32例老年股骨粗隆间骨折患者临床资料,使用骨科手术牵引床进行复位,难复性骨折附加股骨近端外侧行小切口辅助复位,用PFNA内固定治疗。结果:32例患者获得10~24个月随访,骨折愈合时间为4~8个月,根据Harris髋关节评分标准:优28例,良3例,差1例,优良率达到97.1%。结论:运用PFNA治疗老年股骨粗隆间骨折,具有固定可靠、快速康复、缩短住院时间等优点,但同时注意术后股骨髓腔隐性失血的问题,必要时需输血治疗。

Objective:To investigate the efficacy of proximal femoral anti-rotation intramedullary nail(PFNA)in the treatment of senile intertrochanteric fractures of the femur.Methods:32 elderly patients with intertrochanteric fractures admitted to the Eastern Department of orthopedics of our hospital were treated with orthopedic surgery traction bed for reduction.Small incision reduction at proximal side of the femur and PFNA internal fixation were used for treatment of refractory fractures.Results:32 cases were followed up for 10~24 months,and the fracture healing time was 4~8 months.According to Harris hip score,28 cases were excellent,3 cases were good,and 1 case was poor,with a good and good rate of 97.1%.Conclusion:PFNA therapy for senile intertrochanteric fractures has the advantages of reliable fixation,rapid recovery and shorter hospital stay,but at the same time,attention should be paid to the problem of hidden loss of blood in femoral bone marrow cavity,and transfusion therapy should be required if necessary.