急诊闭合复位PFNA治疗青壮年股骨粗隆下骨折16例

Closed reduction and urgent surgery of subtrochanteric fractures with PFNA in 16 young patients

目的评估急诊闭合复位股骨近端抗旋髓内钉(proximal femoral nail antirotation blade,PFNA)治疗青壮年股骨粗隆下骨折的临床疗效。方法对2008年6月~2012年6月经急诊手术治疗的16例青壮年粗隆下骨折进行回顾性分析,男11例,女5例;年龄32~45岁,平均36.2岁。按Seinsheimer分型:ⅡB型2例,ⅡC型1例,ⅢA型6例,ⅢB型1例,Ⅳ型4例,Ⅴ型2例。所有患者急诊手术前均进行美国麻醉学会(ASA)评分,术后对手术时间、术中出血量、完全负重时间和骨折愈合时间进行评估。末次随访采用Parker-Palmer评分标准评估患者术后活动能力。结果本组均获得随访,随访时间为6~28个月,平均13个月。本组患者评分平均为(7.72±1.40)分。结论急诊闭合复位PFNA内固定是治疗青壮年股骨粗隆下骨折的可靠方法,能提供坚强的固定,允许术后早期功能锻炼。

Objective To evaluate the clinical effect of urgent surgery with proximal femoral nail antirotation blade(PFNA) in the treatment of subtrochanteric fractures in young patients.Methods From June 2008 to June 2012,a retrospective analysis was conducted in 16 patients with subtrochanteric fractures.There are 11 males and 5 females,and the average age of the patients was 36.2 years old(range32 to 45 years).According to the Seinsheimer classification,there were 2 cases of type ⅡB,1 cases of type ⅡC,6 cases of type ⅢA,1 cases of type ⅢB,4 cases of type Ⅳ,2 cases of type Ⅴ.The physical status of patient was evaluated according to the American Society of Anesthesiologists(ASA) score before urgent surgery.After the operation,the operation duration and volume of blood loss were assessed.At the last follow-up,full weight bearing time,fracture healing time were assessed.According to the criteria of Parker-Palmer:The mean score was(7.72±1.40) at the final postoperative follow-up.Results The cases were followed up from 6 to 28months,with an average of 13 months.Conclusion Urgent surgery with PFNA is a realiable method to treat subtrochanteric fractures in young patients.It can provide stable internal fixation and earlier exercise.