股骨粗隆间骨折PFNA内固定术后髓内钉远端股骨骨折的治疗（附3例报告）  

Treatment for fracture of femur after intertrochanteric fracture were fixed with PFNA （report of three cases）

作　　者：冯国滨[1] 殷勇[1] 邓伟[1] 弋石泉[1] 谢成[1] 杨帆[1] 

机构地区：[1]四川省绵阳市骨科医院关节创伤外科,四川绵阳621000

出　　处：《医学美学美容（中旬刊）》2013年第9期70-71,共2页

摘　　要：目的：探讨股骨粗隆间骨折PFNA内固定术后髓内钉远端股骨骨折的治疗。方法2011年12月-2012年6月收治的股骨粗隆间骨折PFNA内固定术后髓内钉远端股骨骨折3例患者，1例接受原内固定PFNA取出更换加长PFNA内固定手术，1例接受保留PFNA内固定，行骨折切开复位锁定钢板内固定取髂骨植骨术，1例接受保留PFNA内固定，行骨折切开复位锁定钢板加钢丝捆扎内固定手术。结果3例患者获得13～20个月（平均15．7个月）随访，未出现内固定材料断裂、弯曲、松动脱出。3例骨折已经骨性愈合。结论股骨粗隆间骨折PFNA内固定术后髓内钉远端股骨骨折的治疗，我们对3例患者采用了3种手术方式治疗，体会是更换加长型PFNA创伤小，出血少，约150ml左右，手术时间短80分钟；而采用骨折切开复位锁定钢板固定手术，创伤大，出血多，约600ml-700ml左右，手术时间长150-160分钟。3种手术治疗方式骨折均骨性愈合，医师可以依据患者情况选择治疗方式。Purpose Explore the operative procedures and clinical outcomes of treatment of femoral fractures at intramedullary nail distal after intertrochanteric fracture were fixed with PFNA. Method December 2011 to June 2012, 3 patients had been treated. 1 patient accepted fixating a- gain with longer PFNA . 1 patient accepted continue to have the original internal fixation PFNA and fracture of femur were treated with open re- duction and locking plate fixation, and bone were grafted using ilium. 1 patients accepted to keep the original PFNA fixation and femoral fractures were treated with opened reduction and locking plate fixation and wire binding. Result 3 patients obtain follow-- up for an average of 15.7 （range from 13 to 20）months, It does not happen break or bending or loosening that within-fixed plate or screw or wire or intramedullary nail. 3 case has obtain bony union. Conclusion Treatment for femoral fracture at distal of intrafnedullary nailing after Intertrochanteric fracture were fixed with PFNA, 3 patients were treated using three ways, our experience is that ：the replacement of the lengthened PFNA for treatment the fracture is minimally invasive, less bleeding（about 150ml）, a short time of operation. And the fracture were treated with open reduction and locking plate fixation, there is more trauma, much more bleeding（ about 600- 700ml）, and a long time of operation.

关 键 词：粗隆间骨折 PFNA内固定术后 股骨骨折 治疗 

分 类 号：R682.17[医药卫生—骨科学]