股骨近端防旋髓内钉治疗股骨转子间骨折  

Treatment of intertrochanteric fractures fractures with the proximal femoral nail anti-rotation

作　　者：尚宪平[1] 王小岗[1] 银保[1] 

机构地区：[1]都江堰市人民医院骨科,四川都江堰611830

出　　处：《四川医学》2011年第12期1953-1955,共3页Sichuan Medical Journal

摘　　要：目的探讨股骨近端防旋髓内钉(PFNA)治疗股骨转子间骨折的临床疗效。2009年3月～2011年3月,采用股骨近端防旋髓内钉治疗股骨转子间骨折患者22例。骨折采用闭合复位,股骨近端防旋髓内钉固定术。结果平均手术时间65min(50～90min)。术中平均失血量270ml(150～500ml)。6例患者术中须扩髓即可放入主钉,16例患者术中无须扩髓即可放入主钉,18例患者静力交锁远端螺钉,4例患者未交锁远端螺钉。患者平均部分负重时间9d(6～24d)。平均随访时间9.5个月(6～13个月)。22例患者伤口均一期愈合,骨折愈合时间4～8个月,平均5.2个月。所有患者的术后功能均恢复到伤前水平。1例术后出现拉力螺钉切出移位,1例主钉入点偏外导致13°内翻畸形。结论股骨近端防旋髓内针可以安全地固定股骨转子间骨折。具有微创,手术时间短,出血少,抗旋转能力强,可早期功能锻炼,并发症少,是治疗股骨转子间不稳定性骨折的良好方法。Objective To explore the clinical outcome of intertrochanteric fractures with the proximal femoral nail anti-rotation （PFNA）. Methods Twenty-two patients for intertochanteric fractures of the femur were treated with the proximal femoral nail anti-rotation from March 2009 to March 2011. The fractures were reducted with closed reduction technique and fixed with the proximal femoral nail anti-rotation . Results The mean operative time was 65 rain （50 - 90min）. The mean operative blood loss was 270ml （150 ~ 500ml）. Reaming in 6 cases andunreaming in 16 cases daring operative procedure . With static distal loc- king nail in 18 cases and without distal locking nail in 4 cases . The median time to partical weight-bearing was 9d（ 6 - 24d）. The mean duration of follow up was 9. 5 months （6 - 13months）. The wound healing was smoothly in 22 patients. The average time of fracture heaking was5. 2 months （4 - 8months）. The postoperative fimction was recovered to premorbid status in all patients. One patient occurred the migration of cut-out of lag screw postoperatively. One patient suffered varus deformity in 13° due to the lateral entry, lag pointof the main nail . Conclusion The proximal femoral nail anti-rotation can fixed intertrochanteric fractures safely . wit1 a mina-mally invasive, shorter operative time ,less bleeding, anti-rotation capability, can be an early postoperative functional exercise,less complications,is the treatment of intertrochanteric fractures as a good way.

关 键 词：股骨转子间 骨折固定术 内固定器 

分 类 号：R687.3[医药卫生—骨科学]