股骨近端髓内钉微创治疗80岁以上高龄股骨粗隆间骨折  

Treatment of intertrochanteric fractures over age of 80 years old patients with proximal femur intramedullary nail

作　　者：何永清[1] 阮朝阳[1] 项昶 张纲[1] 朱群威 钱铮[1] 

机构地区：[1]海宁市人民医院骨二科,浙江海宁314400

出　　处：《中国骨伤》2013年第10期833-835,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨股骨近端髓内钉（proximal femur intramedullary nail，PFNA）治疗高龄股骨粗隆间骨折的疗效。方法：对2008年1月至2010年12月收治的86例高龄（80-93岁）股骨粗隆间骨折患者的临床资料进行回顾性分析，其中采用闭合复位PFNA内固定治疗54例（PFNA组），男22例，女32例；采用传统开放复位钉板内固定术32例（对照组），男12例，女20例。比较两组患者的手术时间、出血量、术后并发症、住院时间、骨折愈合时间及髋关节功能情况。结果：所有患者获得2年以上的随访，PFNA组的手术时间、出血量、术后并发症、住院时间均明显少于对照组（P〈0．01）；骨折愈合时间两组差异无统计学意义（P〉0．05）；髋关节功能Harris评分则明显优于对照组（P〈0．01）。结论：应用PFNA治疗高龄患者股骨粗隆间骨折疗效优于传统手术。Objective：To explore the clinical effects of proximal femur intramedullary nail （PFNA） in treating in- tertrochanteric fracture in elderly patients. Methods：From January, 2008 to December, 2010,the data of 86 elderly patients （aged, 80 to 93 years） with intertrochanteric fracture who underwent internal fixation were retrospectively analyzed. Of them, 54 patients （22 males and 32 females） were treated with close reduction and PFNA internal fixation （PFNA group）, and 32 pa- tients （12 males and 20 females） were treated with. open reduction and nail-plate internal fixation （control group）. Operation time, volume of blood loss, postoperative complications, time of hospitalization and bone union,hip function were compared be- tween two groups. Results： All patients were followed up more than 2 years. Operation time, volume of blood loss, postoperative complications,time of hospitalization in PFNA group were less than that of control group （P〈0.01）. There was no significant difference in time of bone union between two groups （P〉0.05）. According to Harris score to evaluate the function of hip joint, PFNA group was better than that of control group （P〈0.01）. Conclusion ：Treatment of elderly patients with intertrochanteric fractures with PFNA internal fixations can obtain satisfactory results ,the method is better than that of traditional method.

关 键 词：股骨 转子间骨折 骨折固定术 髓内 老年人 80以上 

分 类 号：R683.42[医药卫生—骨科学]