PFNAⅡ治疗股骨粗隆间骨折的疗效分析  

Clinical Effect of Improver PFNAⅡ in Fermoral Intertrochanteric Fracture

作　　者：薛志兴[1] 赵尔弘[1] 强华[1] 

机构地区：[1]首都医科大学附属北京同仁医院骨科,北京100730

出　　处：《实用骨科杂志》2013年第6期493-496,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨改进的防旋股骨近端髓内钉(proximal femoral nail anti-rotation-Ⅱ,PFNAⅡ)微创治疗股骨粗隆间骨折的方法及疗效。方法回顾性分析27例股骨粗隆间骨折患者,其中男9例,女18例;年龄29～92岁,平均61岁。按照Evans-Jensen分型,ⅠA型1例,ⅠB型3例,ⅡA型9例,ⅡB型7例,Ⅲ型7例,所有患者均采用闭合复位PFNAⅡ内固定术治疗。分析患者的手术时间、术中出血量,随访骨折愈合情况,采用Harris功能评分评估患髋功能。结果 27例患者均获随访,随访时间4～24个月,平均12个月。本组患者的手术时间为47～130min,平均70.5min,术中出血量为40～120mL,平均78mL。临床愈合时间为2.7～4.1个月,平均3.6个月。Harris功能评分优17例,良7例,可3例,总体优良率88.9%。结论 PFNAⅡ操作简单、创伤小、出血少、手术时间短,螺旋刀片具有很强的抗切出能力,更符合国人的解剖设计,是治疗股骨粗隆间骨折的良好方法。Objective To discuss the method and therapeutic efficacy of improved proximal femoral nail anti-rota- tion- Ⅱ（PFNA M ） in femoral Intertrochanteric fracture. Methods Retrospective analysis of 27 patients of femoral In- tertrochanteric fracture with the method of PFNA Ⅱ . According to the types of Evans-Jensen,we admitted 1 with type I A,3 with type I B,9 with type ⅡA,Twith type ⅡBand 7 with type Ⅱ . All of the patients treated by the methods of improved PFNA ~ after closed reduction. The operative time ,intraoperative bleeding volume and the clinical healing time of fractured bones were analysed. The function of hip joint by Harris scores. Results The operative time in 27 patients was 47~130 min（mean time 70.5 min）. The intraoperative bleeding volume was 40~120 mL（mean volume 78 mL）. The clinical healing time was 2.7~4.1 months （mean time 3.6 months）. The excellent and good rate accord- hg to Hanis scores were 88.9%. Conclusion PFNA I is a good therapeutic method in the treatment of femoral In- tertrochanteric fracture ,with the characteristics of simple manipulation,minimally invasive ,less bleeding and fit to the anatomic structure of Chinese.

关 键 词：股骨骨折 微创 骨折固定术 髓内 防旋股骨近端髓内钉 

分 类 号：R683.42[医药卫生—骨科学]