股骨近端防旋髓内钉-Ⅱ联合外侧支撑钢板治疗外侧壁不稳定型股骨转子间骨折  

Reconstruction treatment for unstable external wall type intertrochanteric fracture by PFNA-Ⅱ combined with lateral supporting plate

作　　者：朱新红[1] 黄飞[1] 周嵘[1] 于凤宾[1] 陶德刚[1] 赖爱宁[1] 郭龙[1] ZHU Xin-hong;HUANG Fei;ZHOU Rong;YU Feng-bin;TAO De-gang;LAI Ai-ning;GUO Long(Army Orthopaedic Trauma Repair and Reconstruction Center of PLA,98th Hospital of PLA,Huzhou 313000,China)

机构地区：[1]解放军第98医院全军创伤骨科修复与重建中心骨二科,浙江湖州313000

出　　处：《骨科》2018年第1期37-41,共5页ORTHOPAEDICS

摘　　要：目的探讨股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)-Ⅱ联合外侧支撑钢板内固定重建治疗外侧壁不稳定型股骨转子间骨折的临床疗效。方法回顾性分析2012年1月至2016年12月于我院通过切开复位、应用PFNA-Ⅱ联合外侧支撑钢板治疗外侧壁不稳定型股骨转子间骨折病人21例,其中男13例,女8例,年龄为31~82岁,平均(56.0±2.3)岁。通过术后随访复查资料评估骨折复位质量及愈合情况,骨折愈合后的髋关节Harris评分(hip Harris score,HHS)用以评价病人的关节功能。结果本组21例病人术后均获得了良好的复位,固定牢固。所有病人均获得随访,随访时间为3~18个月,平均(9.0±2.6)个月,所有病人均获得骨性愈合。术后HHS:优16例,良4例,可1例,优良率为95.2%(20/21)。结论通过PFNA-Ⅱ联合外侧支撑钢板是治疗外侧壁不稳定型股骨转子间骨折的有效方法,保留了股骨转子外侧壁的完整性,增强了骨折端的稳定性,具有较强的坚固性和稳定性,提高了固定疗效。Objective To discuss and evaluate the treatment effectiveness in unstable external wall type intertrochanteric fracture by proximal femoral nail antirotation(PFNA)-Ⅱcombined with lateral supporting plate.Methods From January 2012 to December 2016,21 cases of unstable femoral and lateral wall fractures were treated by open reduction with PFNA-Ⅱcombined with lateral support plate,including 13 males and 8 females,with an average year of(56.0±2.3)years old(range:31-82).The fracture reduction quality and fracture healing quality were assessed by the postoperative follow-up review,and the patients--functions were evaluated according to hip Harris score(HHS)after fracture healing.Results Twenty-one patients in this group received a good reduction and fixation by supporting the reduction of the femoral trochanteric lateral wall fractures and PFNA-Ⅱintramedullary fixation.All patients were followed up for 3-18 months[mean(9.0±2.6)months],and all patients obtained bone healing.According to HHS,16 cases were excellent,4 cases were good and 1 case was general,with the excellent-good rate being 95.2%(20/21).Conclusion PFNA-Ⅱcombined with lateral support plate is an effective way to treat unstable external wall type intertrochanteric fractures by retaining the integrity of the lateral wall of the femur,enhancing the stability of the fracture,so the ruggedness and stability were stronger,and the fixation effect was improved.

关 键 词：股骨转子间骨折 股骨近端防旋髓内钉-Ⅱ 支撑钢板 外侧壁 

分 类 号：R687.3[医药卫生—骨科学]