摘要
目的:探讨应用股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)治疗Basicervical骨折临床疗效及关键技术。方法:回顾性分析2019年3月至2023年3月采用C形臂X线机透视下闭合复位PFNA内固定治疗Basicervical骨折患者23例,其中男9例,女14例;年龄60~69岁7例,70~79岁5例,80~89岁9例,90~99岁2例。记录手术时间、手术出血量、骨折愈合情况,根据Harris评分评价髋关节功能。结果:23例均顺利完成手术,手术时间30~75(60.51±9.82)min;术中出血量100~180(145.36±25.21)ml,隐性失血量150~220(189.00±30.12)ml。23例均获得随访,时间6~28(18.56±6.35)个月。切口均甲级愈合,骨折愈合时间12~15(14.30±1.82)周。随访期间1例发生螺旋刀片切割股骨头,未出现内固定断裂、股骨头缺血性坏死、骨折不愈合、髋内翻畸形、再骨折等并发症。末次随访时采用髋关节功能Harris评分标准评定疗效:优17例,良4例,可1例,差1例。结论:PFNA内固定治疗Basicervical骨折具有操作简单、创伤小、手术时间短、固定牢、术后功能恢复好等优点,是老年Basicervical骨折理想的固定物。
Objective To investigate the clinical efficacy and key techniques of proximal femoral nail antirotation(PFNA)in the treatment of Basicervical fracture.Methods A retrospective analysis was performed on 23 patients with Basicervical fractures who underwent closed reduction and PFNA internal fixation under C-arm X-ray fluoroscopy between March 2019 and March 2023.The cohort included 9 males and 14 females.The age distributions was as follows:7 individuals aged from 60 to 69 years old,5 individuals aged from 70 to 79 years old,9 individuals aged from 80 to 89 years old,and 2 individuals aged from 90 to 99 years old.The operative time,intraoperative blood loss and fracture healing time were recorded.Hip function was evaluated according to the Harris score.Results All 23 patients successfully underwent the operation,with the operation time ranging from 30 to 75 minutes and an average of(60.51±9.82)minutes.The intraoperative blood loss varied from 100 to 180 ml,averaging(145.36±25.21)ml,and the hidden blood loss ranged from 150 to 220 ml,with an average of(189.00±30.12)ml.All 23 patients were followed up,and the duration ranged from 6 to 28 months,with an average of(18.56±6.35)months.All incisions healed well,the fracture healing time ranged from 12 to 15 weeks,with an average of(14.30±1.82)weeks.During the follow-up period,one patient experienced a spiral blade cut-out,and no complications such as internal fixation rupture,avascular necrosis of the femoral head,fracture nonunion,hip varus deformity,or refracture occurred.At the latest follow-up,the results were evaluated by Harris hip function score:17 cases were excellent,4 cases were good,1 case was fair,and 1 case was poor.Conclusion PFNA internal fixation in the treatment of Basicervical fracture has the advantages of simple operation,less trauma,short operation time,rigid fixation,postoperative functional recovery and so on,which is an ideal fixation for elderly Basicervical fracture.
作者
韩雪昆
魏爱淳
蒋剑锋
HAN Xue-kun;WEI Ai-chun;JIANG Jian-feng(Department of Orthopaedics and Traumatology,the Traditional Chinese Medicine Hospital of Haian County,Haian 226600,Jiangsu,China)
出处
《中国骨伤》
2025年第7期676-679,共4页
China Journal of Orthopaedics and Traumatology
