防旋股骨近端髓内钉治疗老年不稳定性股骨转子间骨折的疗效分析  

Effect of proximal femoral nail antirotation in treatment of unstable femoral intertrochanteric fractures in the elderly

作　　者：唐昊[1] 张秋林[1] 汪滋民[1] 禹宝庆[1] 杨长伟[1] 纪方[1] 王秋根[2] 曹磊[1] 李国东[1] 李明[1] 

机构地区：[1]第二军医大学附属长海医院骨科,上海200433 [2]上海交通大学附属上海市第一人民医院骨科

出　　处：《中华创伤杂志》2008年第7期520-523,共4页Chinese Journal of Trauma

摘　　要：目的探讨防旋股骨近端髓内钉（proximal femoral nail antirotation，PFNA）治疗老年不稳定性股骨转子间骨折的疗效。方法2005年12月-2006年10月，采用PFNA治疗老年不稳定性股骨转子间骨折患者65例，其中男22例，女43例；年龄67—97岁，平均78．5岁。均在伤后1周内施行手术。记录每例患者的手术时间、术中出血量、并发症、骨折愈合时间及髋关节功能评分等相关数据，对该治疗方法进行评价。结果术后均随访6—18个月，平均10．5个月。手术时间（29．6±7．5）min，术中出血量（150．5±40．2）ml，骨折愈合时间（9．1±2．2）周。3例早期出现大腿近端疼痛，2例患者出现肺部感染，1例出现下肢静脉血栓，其余患者皆获满意疗效。参照Harris髋关节创伤后功能评分标准，得分为（88．5±6．3）分。结论PFNA具有手术时间短、出血少且固定牢靠的优点，是一种治疗老年不稳定性股骨转子间骨折的好方法。Objective To investigate the treatment effect of proximal femoral nail antirotation （PFNA） on unstable femoral intertrochanteric fractures in the elderly. Methods A retrospective study was done on 65 patients with unstable femoral intertrochanteric fractures, who were treated with PFNA from December 2005 to October 2006 and followed up for at least half a year. There were 22 males and 43 females, at age range of 67-97 （mean 78.5 years）. All the operations were carried out within a week after fractures. The data of operation time, operative blood loss, complications, bone healing time and hip function scores were recorded for evaluating treatment outcomes. Results All the patients were followed up for 6-18 months （ average 10.5 months）. The operation lasted for （ 29.6± 7.5 ） minutes, with mean blood loss of （ 150.5 ± 40.2 ） ml and bone healing time of （ 9.1 ± 2.2 ） weeks. All patients obtained satisfactory treatment results, except for 3 patients with proximal thigh pain, 2 with pulmonary infection occurred and 1 with thrombs of lower limb vein. Harris post trauma hip function score was （ 88.5 ± 6.3 ） points. Conclusion PFNA is an effective way for femoral unstable intertrochanteric fractures in the elderly, for it is characterized by short operation time, less blood loss and stable fixation.

关 键 词：股骨骨折 骨折固定术 髓内 股骨近端髓内钉 

分 类 号：R687.3[医药卫生—骨科学]