摘要
目的探讨闭合复位防旋型股骨近端髓内钉(proximal femoral nail antirotation,PFNA)内固定治疗高龄股骨粗隆间骨折的临床疗效。方法 2008年9月至2010年9月采用闭合复位PFNA内固定治疗股骨粗隆间骨折21例。按Evans分型,Ⅰ型1例,Ⅱ型1例,Ⅲ型12例,Ⅳ型7例。闭合复位,经皮置入PFNA。结果手术时间32～75min,平均46.40min。术中出血量60～140mL,平均84.3mL。18例获得随访,随访时间6～24个月,平均12个月。均获得骨折愈合,且未发现螺旋刀片切割及退出、髋内翻畸形、术后感染等并发症。疗效依照Kuderna改良Merle D′Aubigne标准评估,优13例,良4例,可1例,优良率94.4%。结论 PFNA具有微创、操作简单、手术时间短、出血量少、固定可靠、愈合率高等特点,尤其适用于老年骨质疏松患者,是治疗高龄股骨粗隆间骨折患者理想的内固定物。
Objective To investigate the clinical effects of femoral intertrochanteric fracture in elderly patients with closed reduction and internal fixation using PFNA.Methods From Sep 2008 to Sep 2010,21 patients wih femoral intertrochanteric fractures were treated with closed reduction and internal fixation using PFNA.According to Evans classification,there were 1 case of typeⅠ,1 case of typeⅡ,12 cases of typeⅢ and 7 cases of typeⅣ.Results The mean operating time was 46.40 min（32～75 min）.The mean intraoperative bleeding was 84.3 mL（60～140 mL）.18 patients were followed up for average 12 months（6 to 24 months）.Bone union was achieved in all cases.There was no infection,lag screw cut-out,femoral head necrosis,varus deformity or other comlications.The data were evaluated with Merle D,Aubigne scale system：13 patients were graded as excellent,4 good,and 1 fair.The excellent and good rate was 94.4%.Conclusion It is a reliable and ideal method to treat intertrochanteric fractures with PFNA in elderly patients,because the procedure is convenient and less invasive,resulting in firm fixation,less blood loss,short operation time,and high healinig rate.
出处
《实用骨科杂志》
2012年第6期503-505,509,共4页
Journal of Practical Orthopaedics
