外侧壁保护在股骨近端防旋髓内钉治疗老年股骨转子间骨折中的应用体会  

Application of Lateral Wall Protection for Intertrochanteric Fractures Fixed with Proximal Femoral Nail Antirotation

作　　者：张喜海[1] 卓乃强[1] 鲁晓波[1] 

机构地区：[1]泸州医学院附属医院骨与关节外科,四川泸州646000

出　　处：《华西医学》2014年第2期256-258,共3页West China Medical Journal

摘　　要：目的探讨外侧壁保护技巧在股骨近端防旋髓内钉（PFNA）治疗老年股骨转子间骨折的应用体会。方法将2010年3月-2011年1月收治的60例老年股骨转子间骨折患者，按Evans分型均为不稳定型：Ⅰc型31例，Ⅰd型18例，Ⅱ型11例，采用PFNA治疗，术中采用外侧壁保护理念及技巧。记录骨折愈合及并发症发生情况。结果随访12～18个月，骨折全部愈合，均无感染、髓内钉断裂、螺钉松动断裂及切出股骨头、髋内翻、股骨劈裂等并发症发生。结论PFNA治疗老年股骨转子间骨折具有手术方法简便、固定牢固等优点，但使用时同样需重视外侧壁保护，方能减少额外的并发症发生从而取得良好临床效果。Objective To investigate the lateral wall protection skills for aged femoral intertrochanteric fractures fixed with proximal femoral nail antirotation （PFNA）. Methods Sixty aged patients with femoral intertrochanterie fractures were treated with PFNA between March 210 and January 2011. According to Evans classification, 31 were type Ⅰ c, 18 were Ⅰ d, and 11 were type Ⅱ, Several skills were applied to prevent the breaking of the lateral wall. Post-operative complications, bone union and recovery of hip function were recorded. Results The patients were followed up for 12 to 18 months. All fractures were healed without infection or failure of internal fixation. Conclusions PFNA is a good choice for the clinical treatment of unstable femoral intertrochanteric fractures in aged patients. To obtain better clinical result, the lateral wall must be considered and well protected.

关 键 词：外侧壁 转子间骨折 股骨近端髓内钉 

分 类 号：R687.3[医药卫生—骨科学]