股骨近端防旋髓内钉治疗复杂老年股骨粗隆间骨折的临床疗效及安全性分析  

Clinical Efficacy and Safety Analysis of Anti-rotation Proximal Femoral Nail in the Treatment of Complex Intertrochanteric Fractures of the Elderly

作　　者：缪世昌[1] 黄晓东[1] 戚文元[1] MIAO Shi-chang;HUANG Xiao-dong;QI Wen-yuan(Department of Orthopedics,Jiangyin Hospital of Traditional Chinese Medicine,Wuxi,Jiangsu Province,214400 China)

机构地区：[1]江阴市中医院骨科,江苏无锡214400

出　　处：《系统医学》2020年第18期68-71,共4页Systems Medicine

摘　　要：目的探究股骨近端防旋髓内钉治疗复杂老年股骨粗隆间骨折的安全性。方法筛选2017年1月—2019年9月该科室收治的高龄股骨粗隆间骨折患者40例作为研究对象,所有患者均进行闭合复位股骨近端防旋髓内钉内固定治疗,观察手术治疗状况与治疗预后状况。结果术中出血量(78.4±6.9)mL,手术时间为(61.712.5)min,尖顶距TAD值在(25.7±0.8)mm,术后下地时间为(3.3±1.6)周,所有患者均为骨性愈合;治疗Harris评分在75~92分,平均评分(83.6±2.7)分,预后评估优17例、良15例、一般7例、差1例,治疗有效率为97.50%,术后发生1例感染,未发生骨折愈合不良,深静脉血栓、髋关节内翻、髋关节旋转畸形,临床并发症总发生率为2.50%。结论在高龄股骨粗隆骨折患者中采用闭合复位股骨近端防旋髓内钉内固定治疗,手术治疗状况较好,有较好的临床治疗效果,各项手术指标均较好,治疗预后各项评估患者恢复状况良好,在临床中的整体治疗效果较好,影响临床疗效的主要因素有:患者合并内科疾病,骨折复位质量不佳,内固定位置不良等。Objective To explore the safety of proximal femoral anti-rotation intramedullary nail in the treatment of complex intertrochanteric femoral fractures in the elderly. Methods Screening 40 elderly patients with femoral intertrochanteric fractures admitted to the department from January 2017 to September 2019 as the research objects. All patients received closed reduction and internal fixation with anti-rotation intramedullary nails at the proximal end of the femur. Surgical treatment status and prognosis of treatment was observed. Results Intraoperative blood loss(78.4±6.9) mL, operation time(61.7±12.5) min, apex distance TAD value(25.7±0.8) mm, postoperative landing time was(3.3±1.6) weeks, all patients had bone healing;the treatment Harris score was 75-92 points, with an average score of(83.6±2.7)points. The prognosis assessment was excellent in 17 cases, good in 15 cases, fair in 7 cases, and poor in 1 case.The effective treatment rate was 97.50%, 1 case of infection occurred after operation, no fracture healing, deep vein thrombosis, hip varus, hip rotation deformity, the total incidence of clinical complications was 2.50%. Conclusion In the elderly patients with trochanteric femoral fractures, closed reduction and internal fixation with anti-rotation intramedullary nails of the proximal femur are used. The surgical treatment is good, and there is a good clinical treatment effect. All surgical indicators are good, and the treatment prognosis is different. This item assesses that the patient’s recovery status is good, and the overall clinical treatment effect is good.The main factors affecting clinical efficacy are: patients with medical diseases, poor fracture reduction quality, poor internal fixation position, etc.

关 键 词：骨折闭合复位 PFNA内固定术 高龄 股骨粗隆间骨折 临床疗效 安全性 

分 类 号：R687[医药卫生—骨科学]