股骨近端防旋髓内钉治疗老年股骨粗隆间骨折临床观察

Clinical observation of proximal femoral nail antirotation in the treatment of senile patients with femoral intertrochanteric fracture

目的观察治疗股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折的临床疗效。方法选取医院收治的采用PFNA治疗股骨粗隆间骨折的老年患者292例临床资料及随访资料,并加以整理和归纳。结果 292例患者中术后肺部感染37例,其中因肺部感染死亡8例;患肢深静脉血栓15例,其中并发肺栓塞4例,死亡3例;心脑血管意外32例,死亡13例;凝血功能障碍2例(停用抗凝药物后好转),其他原因死亡4例,共死亡28例。结论PFNA治疗股骨粗隆间骨折疗效确切,手术时机及手术适应证的把握是降低并发症的发生率、减少患者病死率的有效手段。

Objective To observe proximal femoral nail antirotation(PFNA) in the treatment of senile patients with femoral intertrochanteric fracture. Methods The clinical and follow-up date about 292 old patients with femoral intertrochanteric fracture which was treated by PFNA collated and summarized. Results Among 292 senile patients,37 cases of postoperative pulmonary infection which due to lung infection death in 8 cases;15 cases of limb deep vein thrombosis,including 4 cases of pulmonary embolism,death in 3 cases;32 cases of cerebrovascular accident,death in 13 cases;2 cases of coagulation dysfunction( anticoagulant medication is discontinued after the turn for the better) and 4 cases died in other reasons. A total of 28 cases died. Conclusion The efficacy of PFNA in treating senile patients with femoral intertrochanteric fracture is obvious. The key to reduce complications and depressing death rate is determining the operation chance and adaptation.