两种体位行PFNA治疗老年股骨粗隆间骨折的对比研究  

A comparative study on applying two different positions in treating the elderly femoral intertrochanteric fractures with PFNA

作　　者：罗勤瑜[1,2] 胡奕山[1,2] 陈春雷[1,2] 刘伟军[1,2] 洪笃开[1,2] 郭予立[1,2] 林本丹[1,2] 

机构地区：[1]广东省汕头市中心医院 [2]中山大学附属汕头医院骨科,515031

出　　处：《中国矫形外科杂志》2012年第8期681-684,共4页Orthopedic Journal of China

摘　　要：[目的]比较侧卧位和仰卧位行股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)治疗老年股骨粗隆间骨折的临床疗效区别。[方法]回顾分析2008年5月～2010年2月本院收治的68例行股骨近端防旋髓内钉(PFNA)内固定治疗的老年股骨粗隆间骨折患者,其中采用侧卧位徒手牵引36例和仰卧位牵引床牵引32例。对两组手术时间、术中出血量、手术切口长度、骨折愈合时间及术后1年Harris髋关节功能评分进行比较。[结果]侧卧位组在手术时间、术中出血量、手术切口长度方面比仰卧位组有优势(P<0.05),而在骨折愈合时间及术后1年髋关节功能评分方面两组比较无显著性差异(P>0.05)。[结论]侧卧位行PFNA治疗老年股骨粗隆间骨折具有手术时间短、创伤小、出血少、操作简单、术后恢复快等优点,值得推广。[ Objective] To compare the therapeutic effect of applying two different positions in treating the elderly femoral intertrochanteric fractures with proximal femoral nail antirotation（PFNA）. [ Method] From May 2008 to February 2010,68 eld- erly patients with intertrochanteric fractures were treated with PFNA, including 36 cases manual traction in the lateral decubitus position and 32 cases fracture -table traction in the supine position. The operative time, blood loss during operation, the length of incision, the fracture healing time and Harris score of postoperative 1 year were compared in our study. [ Result ] The lateral posi- tion group had more advantage than the supine position group in operative time, the blood loss during the operation and the length of incision（ P 〈 0.05 ）, but had no advantage in fracture healing time and hip joint function of postoperative 1 year（ P 〉 0. 05 ）. [ Conclusion] Treating the elderly femoral intertrochanteric fractures with PFNA in lateral decubitus position is worth promoting, with the advantages of shorter operative time, less invasion,less blood loss, simple operation and fast recovery postoperatively.

关 键 词：侧卧位 股骨近端防旋髓内钉 手术体位 老年 股骨粗隆间骨折 

分 类 号：R687.3[医药卫生—骨科学]