闭合复位PFNA方法治疗老年股骨粗隆间骨折的临床疗效分析  

Clinical efficacy analysis of closed reduction PFNA in the treatment of intertrochanteric fracture in the elderly

作　　者：郭伟华[1] 王虎[1] 李保良[1] 孙景福[1] 罗军[1] 吴任涛[1] 刘小鹏[1] 

机构地区：[1]东莞市厚街医院骨科,523960

出　　处：《中国实用医药》2017年第32期18-20,共3页China Practical Medicine

摘　　要：目的探讨闭合复位防旋型股骨近端髓内钉(PFNA)方法治疗老年股骨粗隆间骨折的临床疗效。方法回顾性分析88例老年股骨粗隆间骨折患者的病历资料,观察PFNA方法应用于老年股骨粗隆间骨折临床治疗的效果,指标包括髋关节功能恢复情况、手术时间、骨折愈合时间、手术出血量、术后并发症。结果本组88例患者平均手术出血量为(109.48±40.24)ml、平均手术时间为(45.28±10.16)min,随访时间内88例骨折均愈合,平均愈合时间为(16.36±2.77)周。不同性别患者的手术时间、手术出血量、骨折愈合时间比较,差异无统计学意义(P>0.05)。术后1年行Harris评分评价髋关节功能,优良率为95.5%。88例患者均未发生骨折不愈合、下肢静脉血栓形成、髋内翻及内固定松动等情况,术后2例关节僵硬、1例切口感染,并发症发生率为3.4%。结论老年股骨粗隆间骨折采用PFNA治疗可取得良好的治疗效果,术后并发症少,关节功能恢复良好。Objective To investigate the clinical efficacy of closed reduction proximal femoral nail antirotation（PFNA） in the treatment of intertrochanteric fracture in the elderly. Methods The medical data of 88 elderly patients with intertrochanteric fractures were retrospectively analyzed. The effects of PFNA method for treatment of intertrochanteric fracture in the elderly were observed. The indexes included hip function recovery, operation time, fracture healing time, surgical bleeding volume and postoperative complications. Results 88 patients had mean surgical bleeding volume as（109.48±40.24） ml, mean operation time as（45.28±10.16） min. During the follow-up period, 88 cases all fractures healed, with mean healing time as（16.36±2.77） weeks. There was no significant difference in the operation time, surgical bleeding volume and fracture healing time in the patients of different genders（P〈0.05）. The hip function was evaluated by Harris score at 1 years after operation, and the excellent and good rate was 95.5%. 88 cases had no fracture nonunion, lower extremity vein thrombosis, hip varus and internal fixation loosening. There were 2 cases of joint stiffness, 1 case of incisional infection, with the incidence of complications as 3.4%. Conclusion PFNA treatment provides excellent treatment effect for the treatment of elderly patients with intertrochanteric fracture with less complications, and the joint function recovers well.

关 键 词：老年 股骨粗隆间骨折 闭合复位 防旋型股骨近端髓内钉 疗效 

分 类 号：R687.3[医药卫生—骨科学]