股骨近端防旋髓内钉治疗股骨转子间骨折

Proximal femoral nail antirotation in the treatment of intertrochanteric fracture

目的探讨股骨近端防旋髓内钉(PFNA)治疗股骨转子间骨折的临床疗效。方法采用闭合复位PFNA治疗46例股骨转子间骨折患者。记录手术时间、术中出血量及术后并发症发生情况,末次随访时采用髋关节功能Harris评分评价疗效。结果手术时间40~120 min,术中出血量30~100 ml。患者均获得随访,时间6~36个月。骨折均一期愈合,无切口感染、深静脉血栓形成、螺旋刀片切割股骨头、断钉等并发症发生。末次随访时根据髋关节功能Harris评分评价疗效:优38例,良7例,可1例,优良率97.8%。结论闭合复位PFNA治疗股骨转子间骨折创伤小,固定可靠,可早期恢复髋关节功能,有效减少并发症。

Objective To investigate the clinical effect of proximal femoral nail antirotation(PFNA)in the treatment of intertrochanteric fracture of femur.Methods The 46 patients with intertrochanteric fractures were treated with closed reduction and PFNA.The operation time,intraoperative blood loss and postoperative complications were recorded,and the Harris score criterion of hip function were used to evaluate the efficacy at the last follow-up.Results The operative time was 40~120 min and the intraoperative blood loss was 30~100 ml.The 46 patients were followed up for 6~36 months.All fractures were healed in the first stage,and there were no complications such as incision infection,deep vein thrombosis,spiral blade cutting out of femoral head,and screw breakage.At the last follow-up,the Harris score of hip function was excellent in 38 cases,good in 7 cases,fail in 1 case,with an excellent and good rate of 97.8%.Conclusions Closed reduction and PFNA for treatment of intertrochanteric fracture of femur has the advantages such as less trauma,reliable fixation,early recovery of hip function,and reduction of complications.