摘要
目的探讨撬拨复位股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折的疗效。方法采用撬拨复位PFNA治疗21例老年股骨转子间骨折患者。记录手术时间、术中出血量、骨折复位情况、骨折愈合情况、髋关节活动度及并发症发生情况,采用Sanders评分标准评估疗效。结果手术时间50~70 min,术中出血量40~65 ml。骨折均满意复位。患者均获得随访,时间3~10个月。骨折均愈合,时间11~14周。未发生切口感染、内固定松动或断裂等情况。术后3个月髋关节活动度:屈曲120°~130°,后伸5°~10°,外展40°~50°,内收10°~20°,外旋20°~30°,内旋10°~20°。末次随访时,按照Sanders评分标准评定疗效:优18例,良3例。结论采用撬拨复位PFNA治疗老年股骨转子间骨折具有创伤小、骨折复位满意、术后关节功能恢复好等优点。
Objective To explore the efficacy of prying reduction and proximal femoral nail anti-rotation(PFNA)in the treatment of intertrochanteric femoral fracture in the elderly.Methods The 21 elderly patients with intertrochanteric femoral fractures were treated with prying reduction and PFNA.The operation time,intraoperative blood loss,fracture reduction,fracture healing,hip joint range of motion and the occurrence of complications were recorded.The therapeutic effect was evaluated using the Sanders post-traumatic hip joint functional scoring system.Results The operation time was 50~70 min and the intraoperative blood loss was 40~65 ml.All fractures achieved satisfactory reduction.All patients were followed up for 3~10 months.All fractures healed within 11~14 weeks.No incision infection,loosening or fracture of internal fixation occurred.Three months after the operation,the range of motion of the hip joint:Flexion was 120°~130°,posterior extension was 5°~10°,abduction 40°~50°,and adduction 10°~20°,external rotation 20°~30°,internal rotation 10°~20°.At the last follow-up,the therapeutic effect was evaluated according to the Sanders scoring standard:The 18 cases were excellent,and 3 cases were good.Conclusions In the treatment of intertrochanteric femoral fracture in the elderly,the use of prying reduction and PFNA has the advantages of less trauma,satisfactory fracture reduction,and good recovery of joint function after surgery.
作者
付静
赵英焕
张智盛
张磊
叶雪卉
孙栋
FU Jing;ZHAO Ying-huan;ZHANG Zhi-sheng;ZHANG Lei;YE Xue-hui;SUN Dong(Dept of Orthopaedics,the Medical Health Group of TCM Hospital of Xiangshan County,Ningbo,Zhejiang 315700,China)
出处
《临床骨科杂志》
2025年第6期878-880,共3页
Journal of Clinical Orthopaedics
关键词
股骨转子间骨折
股骨近端防旋髓内钉
撬拨复位
克氏针技术
intertrochanteric femoral fracture
proximal femoral nail anti-rotation
prying reduction
Kirschner wire technique
