股骨近端防旋髓内钉固定治疗中老年股骨转子间骨折

The proximal femoral nail anti-rotation for middle-aged and old femoral intertrochanteric fracture

目的 探讨股骨近端防旋髓内钉(PFNA)固定治疗中老年股骨转子间骨折的疗效。方法 采用PFNA固定治疗25例中老年股骨转子间骨折患者。记录手术情况、影像学指标、疼痛VAS评分以及髋关节功能Harris评分。结果 患者均获得随访,时间12~14(12.5±1.2)个月。手术时间45~90(65.3±7.8)min,术中出血量45~120(89.5±10.2)ml,术中透视5~15(7.8±2.1)次,住院时间5~10(7.2±1.9)d。骨痂开始形成时间1.5~4.0(2.64±0.55)个月,骨折愈合时间3.5~6.0(4.27±0.85)个月。末次随访时,疼痛VAS评分为0~3(1.4±0.3)分;髋关节功能Harris评分为55~95(85.9±9.2)分,其中优8例,良10例,可5例,差2例,优良率为18/25。结论 PFNA固定治疗中老年股骨转子间骨折创伤小,固定牢靠,髋关节功能恢复好,临床疗效确切。

Objective To investigate the effect of proximal femoral nail anti-rotation(PFNA)fixation in the treatment of middle-aged and old femroal intertrochanteric fracture.Methods The 25 middle-aged and old femroal intertrochanteric fractures were treated with PFNA fixation.Surgical outcomes,imaging indicators,pain VAS and Harris score of hip function were recorded.Results All patients were followed up for 12~14(12.5±1.2)months.The operative time was 45~90(65.3±7.8)min,the intraoperative blood loss was 45~120(89.5±10.2)ml,the intraoperative fluoroscopy were 5~15(7.8±2.1)times,and the hospital stay was 5~10(7.2±1.9)d.The time of callus formation was 1.5~4.0(2.64±0.55)months,and the time of fracture healing was 3.5~6.0(4.27±0.85)months.At the last follow-up,the pain VAS was 0~3(1.4±0.3)points.The Harris score of hip function was 55~95(85.9±9.2)points,of which 8 cases were excellent,10 cases were good,5 fair,and 2 poor,the excellent-good rate was 18/25.Conclusions PFNA fixation for treatment of middle-aged and old femoral intertrochanteric fracture has less trauma,stable fixation and good functional recovery of hip joint,with curative efficacy.