摘要
目的:对应用股骨近端髓内钉内固定治疗不稳定性老年股骨转子间骨折的疗效进行分析。方法:2006年9月至2009年9月收治90例不稳定性老年股骨转子间骨折,其中女50例,男40例,平均年龄73.2岁(64～95岁);右髋骨折50例,左髋骨折40例。根据AO分型进行分类,A2.1型11例,A2.2型21例,A2.3型25例,A3.1型9例,A3.2型6例,A3.3型18例。受伤至手术时间平均3.2d(2～20d),平均住院时间12.8d(7～24d)。均采用闭合牵引复位,股骨近端髓内钉内固定,术后采用Harris髋部评分标准进行疗效分析。结果:平均手术时间36.8min(23～110min),平均出血量150ml(100～500ml)。90例获随访,时间6～24个月,平均12个月,全部获得骨性愈合,复位优69例,良14例,差7例,平均颈干角135.6°(126°～147°)。术后并发症:髋内翻2例,大转子顶点骨化性肌炎5例,螺钉切出1例,股骨近端疼痛7例,患肢短缩10例,平均短缩9.3mm(8～14mm)。术后Harris髋部评分平均(80.5±9.8)分,优26例,良37例,中18例,差9例。结论:股骨近端髓内钉内固定治疗不稳定性老年股骨转子间骨折手术创伤小,操作简单,固定可靠,功能锻炼时间早,疗效满意。
Objective：To investigate the clinical results of the proximal femoral nail antirotation（PFNA） system in the treatment of unstable intertrochanteric femoral fractures.Methods：From September 2006 to September 2009,90 patients（40 males and 50 females,ranged in age from 64 to 95 years with an average of 73.2 years with unstable intertrochanteric femoral fractures were surgically treated with PFNA.Fifty patients had the fractures in the right hip,and 40 patients had the fractures in the left hip.The fractures were classified according to the AO classification：11 patients were type A2.1,21 patients were type A2.2,25 patients were type A2.3 9 patients were type A3.1,6 patients were A3.2 and 18 patients were A3.3.The patients underwent surgery within a mean of 3.2 days（ranged,2 to 20.1 days） from injury.The mean hospital stay was 12.8 days（ranged,7 to 24 days）.Closed reduction was achieved in all the patients.Harris hip score were used for the evaluation of clinical effects.Results：The mean operation time was 36.8 min（ranged,23 to 110 min） and the mean blood loss was 150 ml（ranged,100 to 500 ml）.The mean follow-up period was 12 months（ranged,6 to 24 months）.All the patients had fracture union.Sixty-nine patients got excellent reduction,14 good and 7 bad.The mean collodiaphysial angle was 135.6°（ranged,126° to 147°）.Postoperative complications included secondary varus in 2 patients,calcification at the tip of the greater trochanter in 5 patients,medial thigh pain in 7 patients,and screw cut-out in 1 petient.Ten patients had femoral shortness（mean 9.3 mm,ranging from 8 to 14 mm）.The mean Harris hip score was（80.5±9.8）.According to Harris hip scores evaluation system,26 patients reached an excellent result,37 good,18 poor and 9 bad.Conclusion：Due to advantages of high union rate,short operation time,and early postoperative mobilization,PFNA osteosynthesis is an idea method for surgical treatment of unstable intertrochanteric femoral fractures.
出处
《中国骨伤》
CAS
2011年第8期645-647,共3页
China Journal of Orthopaedics and Traumatology
关键词
股骨骨折
骨折固定术
内
髋关节
老年人
Femoral fractures
Fracture fixation
internal
Hip joint
Aged
