股骨近端髓内钉在股骨转子间骨折中的应用  

Reports of proximal femoral nail in treatment of femoral intertrochanteric fractures

作　　者：高明杰[1] 黄明[1] 季明娟[1] 秦骥[1] 冯磊[1] 杨德顺[1] 

机构地区：[1]安徽省蚌埠市第三人民医院骨科,233000

出　　处：《淮海医药》2009年第4期285-286,共2页Journal of Huaihai Medicine

摘　　要：目的探讨股骨近端髓内钉（proximal femoral nail,PFN）治疗股骨转子间骨折。方法2002年7月-2008年6月,采用PFN治疗60岁以上股骨转子间骨折82例,其中男34例,女48例;平均年龄76.5岁。骨折分型按Ev-ans-Jensen分类分型：Ⅰ型10例,Ⅱ型17例,Ⅲ型37例,Ⅳ型14例,Ⅴ型4例,手术时间平均距受伤时间9 d,记录每例患者并发症、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。结果随访时间4-21个月,平均12.2个月,骨折愈合时间4.3个月,所有手术切口无感染,均一期愈合,平均住院时间为23.3 d。所有患者骨折均愈合,愈合率为100%。其中患肢髋内翻6例,近端拉力螺钉退出4例。功能恢复按Harris标准：优49例,良17例,可9例,差7例,优良率80.5%。结论PFN具有手术时间短、出血少且固定牢靠的优点,是一种治疗老年股骨转子间骨折的好方法。Objective To investigate the treatment effect of proximal femoral nail （PFN）on femoral intertrochanteric fracures in the elderly. Methods A retrospective study was done in 82 cases with femoral intertrochanteric fractures treated with PFN from July 2002 to October 2007. All cases were followed up, of which 34 cases were male and 48 female with the average age of 76.5. Fractures were classified according to Evans-Jensen method：Type Ⅰ 10 cases,Type Ⅱ 17 cases,Type Ⅲ 37 casos,Type Ⅳ 14 cases and Type Ⅴ 4 cases. The mean operative timing was 9 days away from the injury. The complications of each case,fracture healing time,functional hip score and other related data were recorded for the evaluation of treatment outcomes. Results All the patients were followed up for 4 - 21 months （ average 12.2 months）. The fracture healing time was 4. 3 months. All the surgical incision had no infection. The average length of hospitalization was 23.3 days. All fractures healed after treatment. Of all the cases coxa vara of the injured limb occurred in 6 cases and lag-screws dropping-out in 4 cases. Condusion PFN is an effective way for femoral intertrochanteric fractures in the elderly,which is characterized by shorter operative time, less bleeding and stabler fixation.

关 键 词：股骨转子间骨折 骨折固定术 内 股骨近端髓内钉 外科手术 

分 类 号：R683.42[医药卫生—骨科学]