老年骨质疏松性股骨粗隆间骨折PFNA内固定术后失败的原因分析及治疗体会  

The failure reasons and treatment experience related to failed internal fixation of Analysis on failure in PFNA internal fixation for senile osteoporotic femoral intertrochanteric fracture

作　　者：陈继铭[1] 林栢云 钟环[1] 吴新诱 孙文皋 

机构地区：[1]广东医学院附属医院骨科中心,广东湛江524001

出　　处：《广东医学院学报》2015年第3期288-292,共5页Journal of Guangdong Medical College

基　　金：广东省科技计划项目(No.2010B031600288)

摘　　要：目的分析老年骨质疏松性股骨粗隆间骨折股骨近端防旋髓内钉(PFNA)内固定术后失败的原因及总结治疗体会。方法老年骨质疏松性股骨粗隆间骨折患者40例,采用PFNA内固定治疗,分析内固定失败的原因。结果内固定术后失败5例,其中螺旋刀片切割、穿出股骨头颈1例,骨折端再移位3例,髋部深部感染1例,失败率12.5%,按Sanders评分标准优良率达87.5%。结论老年骨质疏松性股骨粗隆间骨折行PFNA内固定术后失败的原因与患者自身因素、骨折类型、手术操作等相关。充分重视老年患者病情的特点,选择合适的内固定方式,标准的手术操作,完善的术后功能锻炼计划,以及进行规范的抗骨质疏松的治疗,是避免内固定失败的有效方法。Objective To investigate the reasons for failed internal fixation of osteoporotic femoral intertrochanteric fractures in elderly patients and summarize treatment experiences. Methods PFNA internal fixation was used for the treatment of senile osteoporotic intertrochanteric fracture in 40 cases. The reasons for the failure in internal fixation were analyzed. Results 5 cases failed after internal fixation, of which there was 1 case with the spiral blades cutting through the femoral head and neck, 3 cases with fracture end displacement, and 1 case with hip deep infection, and the failure rate was 12.5%. According to Sanders score, the excellent and good rate was 87.5%. Conclusion The failure in internal fixation of osteoporotic femoral intertrochanteric fractures in elderly patients is related to personal factors of the patient, type of fracture, and surgical operations. Paying full attention to the characteristics of elderly patients, choosing suitable internal fixation method, selecting standard operation, developing postoperative functional exercise program and conducting standard anti-osteoporosis therapy are all effective methods to prevent internal fixation failure.

关 键 词：股骨粗隆间骨折 老年骨质疏松 PFNA 内固定 

分 类 号：R683.42[医药卫生—骨科学]