微创手术治疗老年性不稳定股骨粗隆间骨折的临床观察  

The study on clinical effectiveness of minimally invasive operating procedures for unstable femoral intertrochanteric fracture in aged patients

作　　者：熊发明[1] 吴冰[1] 孙大连[1] 许宁宁[1] 胡晓辉[1] 

机构地区：[1]安徽省宣城中心医院骨科,242000

出　　处：《中国实用医药》2012年第24期47-48,共2页China Practical Medicine

摘　　要：目的观察抗旋转股骨近端髓内钉(Proximal femoral nail antirotation,PNFA)微创手术治疗老年不稳定股骨粗隆间骨折的临床疗效。方法自2010年5月至2011年6月回顾性研究老年性不稳定股骨粗隆间骨折35例,男9例,女26例,年龄65～92岁,平均74.3岁。按改良Jensen-Evans分型:ⅢA型14例,ⅢB型9例,Ⅳ型2例。均合并不同程度的骨质疏松。在C型臂透视下闭合复位经皮小切口PFNA内固定治疗。结果手术时间45～85min,平均63.9min;术中出血50～150ml,平均80ml,手术切口3～6cm,平均5cm。随访时间6～12个月,平均8.7个月。骨折全部愈合,愈合时间9-18周,平均12.5周。按Harris髋关节功能评分标准:优25例,良8例,可2例,优良率为94.3%。结论经皮微创PFNA治疗老年性不稳定股骨粗隆间骨折疗效良好,具有骨折固定牢固,创伤小,术后并发症少等优点。Objective To explore clinical effectiveness of minimally invasive operating procedures with proximal femoral nail antirotation（PNFA） for unstable femoral intertrochanteric fracture in aged patients.Methods In a prospective study 35 aged patients with unstable femoral intertrochanteric fracture were teated with PFNA fixation under the guidance of fluoroscopy,closed reduction,minimally invasive incision from May 2010 to June 2011.They were 9 males and 26 females,with an average age of 74.3（65 to 92 years）years.According to Jensen-Evans classification.there were 14 cases of ⅢA,9ⅢB,and 2Ⅳ.Results 35 patients were foHowed up for 6~12 months（averaged 8.7 months）.Fracture union Was achieved in alI patients with a mean healing time of 12.5（9 to 18）weeks.According to Harris criterion,the resuIts of 25 exceIIent cases and 8 good cases were obtained.The excellent and good rate of the function of the hip joint was 94.3%.Operation time 45~85 minutes（aveaged 63.9 minutes）,Operation bleeding 80~250 ml（averaged 130 ml）,Operative incision 3~6 cm（averaged 5 cm） Conclusion Minimally invasive operating procedures with proximal femoral nail antirotation（PNFA） for unstable femoral intertrochanteric fracture in aged patients is a useful treatment.It has advantages of less surgical trauma,stabIe fixation,less complications.

关 键 词：股骨粗隆间骨折 抗旋转股骨近端髓内钉 微创手术 骨折固定 

分 类 号：R687.3[医药卫生—骨科学]