亚洲型股骨近端抗旋髓内钉微创治疗老年不稳定股骨转子间骨折  

Minimally Invasive Treatment of Elderly Unstable Femoral Intertrochanteric Fracture with Proximal Femoral Nail Anti-rotation Ⅱ

作　　者：高均宏 朱海涛[1] 冯健[1] 王文跃[1] 胡祖愉 王俭[1] 胡江[1] 刘洪新[1] 

机构地区：[1]浙江省海盐县人民医院骨科,海盐314300

出　　处：《中国微创外科杂志》2011年第9期841-843,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨亚洲型股骨近端抗旋髓内钉（proximal femoral nail anti-rotationⅡ,PFNA-Ⅱ）治疗老年不稳定股骨转子间骨折的临床效果。方法 2009年2月-2010年10月对46例老年不稳定股骨转子间骨折采用闭合牵引复位,小切口置入PFNA-Ⅱ。结果手术时间45-100 min,平均60 min。出血80-440 ml,平均120 ml。术后住院5-14 d,平均9 d。42例随访4-18个月,平均8个月：骨折全部愈合,愈合时间10周-6个月,平均13周;未出现髋内翻,内固定物失效及切割现象;按Harris髋关节功能评分,优26例,良10例,中4例,差2例,优良率85.7%（36/42）。结论 PFNA-Ⅱ内固定具有操作简单、固定可靠的特点,是目前治疗老年不稳定股骨转子间骨折理想的内固定材料。Objective To explore the clinical effects of proximal femoral nail anti-rotation Ⅱ（PFNA-Ⅱ） in the treatment of elderly unstable femoral intertrochanteric fracture.Methods Totally 46 elderly patients with unstable femoral intertrochanteric fractures were treated by PFNA-Ⅱ from February 2009 to October 2010.The patients received manipulative traction and closed reduction.Results The mean operation time in this series was 60 min（45-100 min）,during which 80-144 ml（mean,120 ml） blood loss was measured.The patients were discharged from hospital 5-14 days after the operaiton（mean,9 days）,after that 42 of them received a follow-up for 4-18 months（mean,8 months）,which showed fracture reunion in 10 weeks to 6 months（mean,13 weeks） without occurence of varus deformity,hardware loosening or hardware cutting.According to Harris Hip score,26 cases achieved excellent results,10 were good,4 were fair and 2 were poor.The excellent and good rate of the hip joint function was 85.7%（36/42）.Conclusions It is an ideal method to treat unstable femoral intertrochanteric fracture with PFNA-Ⅱ in elderly patients.The procedure is convenient and the fixation is stable.

关 键 词：股骨近端抗旋髓内钉 股骨转子间骨折 内固定 

分 类 号：R687.3[医药卫生—骨科学]