摘要
目的探讨采用头髓钉下移支持内侧皮质植入技术在股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)固定治疗内侧壁缺损型股骨转子间骨折的临床疗效。方法分析2021年6月至2024年6月中国人民解放军联勤保障部队第九一〇医院采用头髓钉下移支持内侧皮质植入技术行PFNA固定治疗26例内侧壁缺损型股骨转子间骨折患者资料,记录手术时间、术中出血量、骨折愈合时间、并发症发生情况和末次随访髋关节功能Harris评分。结果患者均获得随访,随访时间6~12个月。手术时间20~45(32.7±7.9)min,术中出血量100~350(223.1±63.6)m L,骨折愈合时间10~16周,未出现切口感染、骨折不愈合、头髓钉松动、头颈骨折块内翻等并发症,末次随访时髋关节功能Harris评分优良率为92.3%。结论内侧壁缺损型股骨转子间骨折PFNA固定术中采用头髓钉下移支持内侧皮质植入技术有利增强内侧支撑,降低头颈骨折块内翻的风险,该方法操作简单,固定可靠,临床效果满意。
Objective To investigate the clinical effects of moving the helical blade of the PFNA down to abut the medial cortex of the femoral neck in the treatment of intertrochanteric femoral fractures with a medial wall defect.Methods From June 2021 to June 2024,26 patients with a femoral intertrochanteric fracture and a medial wall defect who were treated at the 910th Hospital of the Joint Logistics Support Force of the PLA with PFNA fixation and the technique of moving the helical blade of the PFNA down to abut the medial cortex of the femoral neck were observed.The operation duration,intraoperative blood loss,time taken for the fracture to heal,adverse events,and Harris hip function score at the final follow-up were recorded.Results All patients were followed up for 6 to 12 months.The operation duration ranged from 20 to 45(32.7±7.9)mins,intraoperative bleeding loss ranged from 100 to 350(223.1±63.6)mL,fracture healing time ranged from 10 to 16 weeks,no adverse events such as incision infection,fracture non-union,helical blade loosening,femoral head varus occurred.The Harris hip function score at the final follow-up was 92.3%.Conclusion The technique of moving the helical blade downwards in PFNA is beneficial in enhancing medial cortex support and reducing the risk of femoral head varus.It is easy to perform and provides reliable fixation,resulting in satisfactory clinical outcomes.
作者
肖奕增
黄东海
王清铿
赵枫
尤瑞金
陈昆
Xiao Yizeng;Huang Donghai;Wang Qingkeng;Zhao Feng;You Ruijin;Chen Kun(Department of Orthopedics,The 910th Hospital of the Joint Logistics Support Force of the PLA,Quanzhou Fujian,362000,China)
出处
《生物骨科材料与临床研究》
2025年第5期45-49,共5页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
股骨转子间骨折
内侧壁缺损型
头髓钉下移
股骨近端防旋髓内钉
Intertrochanteric fracture
Medial wall defect
Helical blade move down
Proximal femoral nail anti-rotation
