有限切开辅助复位防旋股骨近端髓内钉治疗不稳定股骨转子间骨折  

Treatment of unstable femoral intertrochanteric fracture with limited incision and auxiliary reduction fixation with proximal femoral nail anti-rotation

作　　者：牛海明[1] NIU Hai-ming(Section Ⅰ,Dept of Orthopaedics,the People′s Hospital of Guanyun County,Lianyungang,Jiangsu 222200,China)

机构地区：[1]灌云县人民医院骨一科,江苏连云港222200

出　　处：《临床骨科杂志》2018年第5期597-598,共2页Journal of Clinical Orthopaedics

摘　　要：目的探讨有限切开辅助复位防旋股骨近端髓内钉(PFNA)治疗不稳定股骨转子间骨折的疗效。方法采用有限切开辅助复位PFNA内固定技术治疗23例不稳定股骨转子间骨折患者。根据影响复位的不同情况采用有限切开器械撬拨或钢丝环扎辅助复位治疗。结果骨折复位情况:优17例,良4例,差2例。术后1例死于肺栓塞,1例失联,21例获得随访,时间9～21个月。21例骨折愈合,愈合时间为10～22周。末次随访根据髋关节Harris评分标准评定疗效:优14例,良4例,可2例,差1例,优良率为18/21。结论采用有限切开器械辅助复位PFNA治疗不稳定股骨转子间骨折能保护骨折端血运,减少软组织剥离,骨折复位相对满意,可提高手术治疗的成功率。Objective To investigate the effect of limited incision and auxiliary reduction proximal femoral nail anti-rotation（PFNA） for treatment of unstable femoral intertrochanteric fracture. Methods The 23 cases of unstable femoral intertrochanteric fracture were treated with limited incision and PFNA internal fixation. In accordance with the different conditions that affected the reduction, a limited incision device was used or a steel wire ring was used for auxiliary reduction. Results The fracture reduction was excellent in 17 cases, good in 4 and poor in 2. In this group, 1 case died of pulmonary embolism, 1 case was lost, and 21 patients were followed up for 9~21 months. All 21 cases were healed in 10~22 weeks. At last follow-up, the effect was evaluated according to the Harris function score of the hip, the results were excellent in 14 cases, good in 4 cases, fair in 2 and poor in 1, with an excellent-good rate of 18/21. Conclusions The use of limited incision and instrument auxiliary reduction PFNA fixation for unstable femoral intertrochanteric fractures is a minimally invasive way to achieve relatively satisfactory reduction of fracture, protect the blood flow at fracture ends, reduce soft tissue detachment and improve the success rate of surgical treatment.

关 键 词：转子间骨折 防旋股骨近端髓内钉 骨折固定术 髓内 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]