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老年股骨转子间骨折股骨近端抗旋髓内钉内固定的手术技巧 被引量：4

TECHNICAL TIPS AND SKILLS FOR PROXIMAL FEMORAL NAIL ANTI-ROTATION(PFNA)IN THE TREATMENT OF GERIATRIC INTERTROCHANTERIC HIP FRACTURES
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摘要 目的随着股骨近端抗旋髓内钉(proximal femoral nail anti-rotation,PFNA)在老年股骨转子间骨折治疗中的广泛应用,临床上出现插钉困难、固定不满意的病例逐渐增多。为取得满意疗效,本文着重探讨使用PFNA治疗老年股骨转子间骨折的手术技巧。方法通过总结自身经验并复习文献资料,总结出确保手术成功的10条经验。结果 10条经验:①满意的体位摆放;②良好的骨折复位;③股骨大转子顶点开口应略偏向顶点内侧;④近端高速扩髓;⑤主钉徒手插入;⑥确保抗螺旋刀片在股骨头中的理想位置;⑦TAD确定抗螺旋刀片在股骨头中的深度;⑧谨防股骨干前弓;⑨避免骨折端的分离;⑩正确把握骨折线至锁定钉孔的距离。结论正确掌握PFNA的结构特点与手术技巧,有利于提高插钉成功率与固定质量,确保手术疗效。 Objective To investigate the technical tips and skills of proximal femoral nail anti- rotation in the treatment of geriatric intertrochanteric hip fractures. Methods Ten tips regarding successful nailing and stable fixation were gathered by summary our own experiences and lessons, reviewing related literatures. Results These ten tips included correct patient position in fracture table, perfect fracture reduction, medial shift of entry point from the exact trochanteric tip, high speed reaming, hand insertion of nail without hammer blow, good position of helical blade in femoral head, using TAD to control the depth of helical blade in femoral head,＊ awareness of the femoral anterior cortex, management of the fracture separation, and secure distance from fracture part to the distal locking screw. Conclusion Paying attention to the struc- ture characteristics of PFNA and operation skills can improve the nailing success rate and fixation quality. And it＇s good for curative effect.
作者 司刚 刘磊 蒋建农 莫渊 史智伟 周鸣
机构地区 江苏大学附属宜兴市人民医院骨科
出处 《中国煤炭工业医学杂志》 2013年第9期1501-1503,共3页 Chinese Journal of Coal Industry Medicine
关键词 骨折 股骨转子间 髓内钉内固定 股骨近端抗旋髓内钉 手术技巧 Intertrochanteric fractures Intramedullary nail fixations PFNAs Operative skill
分类号 R683.42 [医药卫生—骨科学]
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参考文献11

  • 1殷勇,周贤杰.股骨近端抗旋髓内钉(PFNA)治疗老年不稳定股骨粗隆间骨折[J].中国骨与关节损伤杂志,2011,26(8):733-734. 被引量：59
  • 2卢世璧.坎贝尔骨科手术学[M].9版.济南:山东科学技术出版社,2003:2022-2023.
  • 3PFNA. Leading the way to optimal stability. Synthes Original instruments and implants of the Association for the Study of Internal Fixation. AO/ASIF[J. Stratec Medical ,2004 . 1 - 44.
  • 4Vidyadhara S, Sharath KR. One and two femoral neck screws with intramedullary nails for unstable tro- chanteric fractures of femur in the elderly - ran - domised clinical trial[-J. Injury,2007,38 806 - 814.
  • 5George J, Haidukewych. Inertrochanteric Fractures: Ten Tips to Improve Results[-J. J Bone Joint Surg (Am), 2009,91 - A.711 - 719.
  • 6Ostrum RF, Marcantonio A, Marburger R. A critical analysis of the eccentric starting point for trochanter- ic intramedullary femoral mailing[-JJ. J Orthop Trau- ma, 2005,19 . 681 - 686.
  • 7张世民.股骨粗隆间骨折中外侧壁的概念及其临床意义[J].中国矫形外科杂志,2010,18(17):1489-1492. 被引量：60
  • 8Baumgaertner MR, Sollberg BD. Awarefiess of tipa- pex distance reduces failure of fixation of troehanter- ic fractures of the hip[-J. J Bone Joint Surg (Br), 1997,79 : 969 - 971.
  • 9Zhou JQ,Chang SM. Failure of PFNA= Helical btade perforation and tip- apex distanceJ. Injury, 2012, 43(7) : 1227 - 1228.
  • 10Ostrum RF,Levy MS. Penetration of the distal femo- ral anterior cortex during intramedullary nailing for subtrochanetric ractures a report of three cases[J. J Orthop Trauma, 2005,19 : 656 - 660.

二级参考文献19

  • 1张经纬,蒋垚,张先龙,冯建翔,杨立峰,赵刘军,吴志军,黄雷,曾炳芳.股骨转子间骨折不同手术方法比较[J].中华骨科杂志,2005,25(1):7-11. 被引量：389
  • 2Gotfried Y. The lateral trochanteric wall: a key element in the recon- struction of unstable pertrochanteric hip fractures [ J ]. Clin Orthop Relat Res .2004.425:82 - 86.
  • 3Im GI, Shin YW, Song YJ. Potentially unstable intertrochanteric fractures [ J]. J Orthop Trauma,2005,1:5 - 9.
  • 4Palm H, Jacobsen S, Sonne - Holm S, et al. Integrity of the lateral fernoral wall in intertrochanteric hip fractures : an important predictor of a reoperation [ J ]. J Bone Joint Surg Am,2007,3:470 -475.
  • 5Gotfried Y. Letter to the editor regarding "Integrity of the lateral femoral wall in intertrochanteric hip fractures : an important predictor of a reoperation" [ J ]. J Bone Joint Surg Am,2007,11:2552 - 2253.
  • 6Sadowski C, Lubbeke A, Saudan M, et al. Treatment of reverse oblique and transverse intertrochanteric fractures with use of an intramedullary nail or a 95 degrees screw - plate: a prospective, randomized study [ J]. J Bone Joint Surg Am,2002,3:372 - 381.
  • 7Bong MR,Patel V,Iesaka K,et al. Comparison of a sliding hip screw with a trochanteric lateral support plate to an intramedullary hip screw for fixation of unstable intertrochanteric hip fractures : a cadaver study [ J]. J Trauma,2004,56:791 - 794.
  • 8Kuzyk PRT, Lobo J, Whelan D, et al. Biomechanical evaluation of extramedullary versus intramedullary fixation for reverse obliquity intertrochanteric fractures [ J ]. J Orthop Trauma,2009,1:31 - 38.
  • 9Madsen JE, Naess L, Aune AK, et al. Dynamic hip screw with trochanteric stabilizing plate in the treatment of unstable proximal femoral fractures: a comparative study with the gamma nail and compression hip screw [ J ]. J Orthop Trauma, 1998,12:241 - 248.
  • 10Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity fractures of the intertrochanteric region of the femur[ J]. J Bone Joint Surg Am, 2001,83:643 -650.

共引文献118

同被引文献37

  • 1祝晓忠,张世民,黄轶刚,王欣.老年股骨粗隆间骨折PFNA-Ⅱ插钉内固定的手术技巧[J].外科研究与新技术,2012,1(2):115-120. 被引量：8
  • 2Simecek M, Simecek K, Svoboda V, et al. PCCP-first choice of the treatment of trochanteric fractures in our orthopaedic department [ J 1 - Rozhl Chir,2010,89(2) :150-158.
  • 3Antonini G, Giancola R, Berruti D, et al. Clinical and functional out- comes of the PCCP study: a multi-center prospective study in Italy [ J ]. Strategies Trauma Limb Reconstr, 2013,8 ( 1 ) : 13-20.
  • 4Ma J, Xing D, Ma X, et al. The percutaneous compression plate versus the dynamic hip screw for treatment of intertrochanteric hip fractures : a systematic review and meta-analysis of comparative studies [ J ]. Orthop Traumatol Surg Res,2012,98(7 ) :773-783.
  • 5Knobe M, Manker R, Sellei RM, et al. Unstable pertrochanteric femur fractures. Failure rate, lag screw sliding and outcome with extra- and intramedullary devices( PCCP, DHS and PFN) [ J 1. Z Orthop Unfall, 2009,147 ( 3 ) : 306 -313.
  • 6Kraus J, Volf V, Burqet F, et al. PCCP versus standard proximal femo- ral nail in the treatment of pertrochanteric femoral fractures[ J-. Rozhl Chir,2009,88 ( 8 ) :469-474.
  • 7Sehmidt RB, Heussen N, Knobe M, et al. Re-operation rate after inter- nal fixation of intertrochanteric femur fractures with the Percutaneous Compression Plate (PCCP) : what are the risk factors? [ J ]. Orthop Trauma,2013,27 (6) :312-317.
  • 8Gupta RK, Sangwan K, Kamboj P, et ah Unstable trochanteric frac- tures: the role of lateral wall reconstruction [ J ]. Int Orthop, 2010,34 (1) :125-129.
  • 9Langford J, Pillai G, Ugliailoro AD, et al. Perioperative lateral tro- chanteric wall fractures:sliding hip screw versus percutaneous com- pression plate for intertrochanteric hip fractures [ J ]. Orthop Trauma, 2011,25 (4):191-195.
  • 10Avakian Z, Shiraev T, Lam L, et al. Dynamic hip screws versus proximal femoral nails for intertrochanteric fracture [J]. anz J surg,2012,82(I-2) :56-59.

引证文献4

二级引证文献23

中国煤炭工业医学杂志
2013年 第9期

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