微创股骨近端防旋髓内钉对股骨转子间骨折预后的影响

Effect of minimally invasive proximal femoral nail antirotation on the prognosis of intertrochanteric fracture of the femur

目的:研究微创股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)对外侧壁完整型和危险型股骨转子间骨折的预后。方法:回顾性分析92例股骨转子间骨折患者资料,根据术前股骨X线片及CT扫描结果分为外侧壁完整型(52例)和外侧壁危险型(40例),2组均经过PFNA手术治疗。结果:外侧壁完整型组的术中出血量、术后首次下床活动时间、住院时间、骨折愈合时间、末次随访时髋关节屈伸活动度及Harris评分均显著优于外侧壁危险型(P<0.05)。结论:微创PFNA用于外侧壁完整型股骨转子间骨折的治疗,具有Harris评分优良率高、骨折愈合和负重所需时间短等优点。

Objective:To study the prognosis of minimally invasive proximal femoral nail antirotation(PFNA)in the treatment of lateral wall intact and dangerous intertrochanteric fractures.Methods:The data from 92 patients with femoral intertrochanteric fractures were retrospectively analyzed.The patients were divided into lateral wall intact type(52 cases,intact group)and lateral wall dangerous type(40 cases,risk group)according to the results of preoperative femoral X-ray and CT scan and were all treated with PFNA.Results:The intraoperative blood loss,postoperative first ambulation time,hospitalization time,fracture healing time,hip flexion and extension activity at the last follow-up and the Harris score were significantly better in the intact group than the risk group(P<0.05).Conclusion:Minimally invasive PFNA for the treatment of intertrochanteric fractures with intact lateral walls has the advantages of high Harris score and short time required for fracture healing and weight-bearing.