PFNA术中器械辅助支撑股骨矩治疗Evans-Jensen Ⅲ型、Ⅳ型股骨粗隆间骨折  

Treatment of intertrochanteric fractures of Evans-Jensen Ⅲ and Ⅳ with instrumentation auxiliary during PFNA operation

作　　者：陈卫东[1] 薛启明[1] 王瑞平[1] 周永其[1] 于明昌[1] 冯欢欢[1] CHEN Wei-dong;XUE Qi-ming;WANG Rui-ping(Department of orthopedics,Taicang Affiliated Hospital of Nanjing University of Chinese Medicine,Taicang 215400, China)

机构地区：[1]南京中医药大学太仓附属医院骨科,江苏太仓215400

出　　处：《吉林医学》2018年第12期2334-2336,共3页Jilin Medical Journal

基　　金：太仓市科技局重点研发计划(社会发展)[项目编号:TC2017SFYL10]

摘　　要：目的:探讨采用PFNA配合术中器械辅助支撑治疗EvansⅢ型、Ⅳ型股骨粗隆间骨折的临床疗效。方法:选择46例Evans-JensenⅢ型、Ⅳ型股骨粗隆间骨折患者,采用PFNA内固定术中配合器械辅助支撑股骨矩治疗,统计术中一次性开口插钉成功率,统计术中出血、手术时间,测量患者术后第1天及术后1年[随访时间11～13个月,平均(12. 22±0. 32)个月]X片的颈干角角度A1d、A1y,计算术后颈干角度丢失度数Ax(Ax=A1y-A1d)、骨折愈合时间,评估术后1年髋关节功能。结果:46例患者PFNA术中器械辅助支撑股骨矩协助复位后一次性插钉成功率100%,术后颈干角丢失度数-(3. 69±0. 68)°,术中出血量为(32. 25±4. 58) ml,手术时间为(48. 76±6. 28) min,骨折愈合时间为(12. 23±0. 34)周。根据髋关节功能Harris评分,其中优31例,良12例,可3例,差0例,优良率93. 48%。结论:PFNA术中器械辅助支撑股骨矩治疗Evans-JensenⅢ型、Ⅳ型股骨粗隆间骨折一次性插钉成功率高,术后髋关节功能优良,值得临床推广。Objective To explore the clinical effect of PFNA combined with intraoperative instrumentation in the treatment of Evans type Ⅲ and Ⅳ femoral intertrochanteric fractures. Method 46 patients with intertrochanteric fracture of Evans-JensenⅢ and Ⅳ were treated with instrument-supported during PFNA operation in our department. To calculate femural neck-shaft angle Ax( Ax = A1 y-A1 d),intraoperative bleeding,operative time,the success rate of one-off nail insertion during operation and evaluate the function of hip joint after operation[from 11 to 13 months,median( 12. 22 ± 0. 32) months]. Results Success rate of one-off nail insertion after assisted reduction with instrument-assisted support in 46 patients with PFNA was 100%. Loss degree of neck shaft angle by postoperative follow-up period was-( 3. 69 ± 0. 68) °,intraoperative bleeding was( 32. 25± 4. 58) ml,operative time was( 48. 76 ± 6. 28) min and fracture healing time was( 12. 23 ± 0. 34) weeks. According to the Harris score of hip function,31 cases were excellent,12 cases were good,3 cases were fair,0 cases were poor. The excellent and good rate was 93. 48%. Conclusion The treatment of intertrochanteric fracture of Evans-Jensen Ⅲ and Ⅳ with instrument-supported during PFNA operation has a high success rate and excellent hip function after operation,so it is worth popularizing in clinic.

关 键 词：股骨粗隆间骨折 股骨近端防旋髓内钉 内固定术 

分 类 号：R687.3[医药卫生—骨科学]