股骨近端防旋髓内钉治疗股骨转子间骨折

The proximal femoral nail anti-rotation for treatment of intertrochanteric fractures of the femur

目的探讨股骨近端防旋髓内钉(PFNA)治疗股骨转子间骨折的疗效。方法采用PFNA治疗39例股骨转子间骨折患者。记录手术时间、术中出血量、骨折复位及愈合情况、并发症发生情况,采用Harris评分评价髋关节功能。结果患者均获得随访,时间3~12个月。术中出血量30~280(127.56±66.09)ml,手术时间40~150(72.69±24.84)min。15例骨折解剖复位,24例骨折功能复位。切口均一期愈合。骨痂形成时间2~5(2.9±0.6)个月,骨折愈合时间3~6(4.2±1.1)个月。术后无骨折断端移位、再骨折、髓内钉断裂等并发症发生,1例出现内固定松动。末次随访时,Harris髋关节功能评分79~95(87.21±5.52)分,优31例,良7例,可1例,优良率97.44%。结论PFNA治疗股骨转子间骨折手术操作简单,手术切口小,术中出血少,患者恢复良好。

Objective To investigate the efficacy of proximal femoral nail anti-rotation(PFNA)in the treatment of femoral intertrochanteric fractures.Methods PFNA was used to treat 39 patients with femoral intertrochanteric fractures.The operation time,intraoperative blood loss,fracture reduction and fracture healing condition were recorded,and Harris score was used to evaluate the hip function.Results All patients were followed up for 3~12 months.The intraoperative blood loss was 30~280(127.56±66.09)ml,and the operation time was 40~150(72.69±24.84)min.Anatomical reduction was achieved in 15 cases,and functional reduction was obtained in 24 cases.All incisions were primary healing.Callus formation time was 2~5(2.9±0.6)months,and fracture healing was 3~6(4.2±1.1)months.There were no complications such as fracture end displacement,re-fracture or intramedullary nail fracture,while there was 1 case of internal fixation loosening.At the last follow-up,the Harris hip function score was 79~95(87.21±5.52)points,31 cases were excellent,7 cases were good,and 1 case was fair,with an excellent-good rate of 97.44%.Conclusions PFNA in the treatment of femoral intertrochanteric femoral fracture has the advantages of simple operation,small incision,less intraoperative blood loss,and good recovery of the patients.