股骨反转子间骨折PFNA内固定失败的影响因素分析  

Analysis of factors affecting failure of internal fixation of PFNA in antitrochanteric fractures of femur

作　　者：邱利杰[1] 刘超 万广宇 Qiu Lijie;Liu Chao;Wan Guangyu(The second department of bone Anyang District Hospital,Anyang Henan455000,China)

机构地区：[1]河南安阳地区医院骨二科,安阳455000

出　　处：《河南外科学杂志》2021年第1期41-43,共3页Henan Journal of Surgery

摘　　要：目的探讨股骨反转子间骨折股骨近端防旋性髓内钉(PFNA)内固定失败的影响因素。方法回顾性分析2015-02—2017-06间在安阳地区医院骨二科接受PFNA治疗的97例股骨反转子间骨折患者的临床资料,其中手术成功81例(成功组),失败16例(失败组)。比较2组患者的一般资料、临床指标,经单因素、多因素Logistic回归分析,得出影响PFNA内固定失败的因素。结果 2组患者的性别、年龄及髓内钉顶点距离位置比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,肥胖、基础疾病、骨质疏松程度、骨折分型、骨折复位情况,以及尖顶距可能是导致股骨反转子间骨折PFNA内固定失败的危险因素(P<0.05)。结论股骨反转子间骨折PFNA内固定失败的影响因素包括肥胖、基础疾病、重度骨质疏松、外侧壁过薄、不稳定性骨折、骨折复位欠佳及尖顶距过大等,应积极防治,以提高手术成功率。Objective To investigate the factors that influence the failure of internal fixation of proximal anti-rotation intramedullary nail(PFNA)in femoral antitrochanteric fracture.Methods The clinical data of 97 patients with intertrochanteric fracture of femur treated with PFNA in our hospital from February 2015 to June 2017 were retrospectively analyzed,including 81 patients(successful group)and 16 patients(failed group)with successful surgery.General data and clinical indicators of the two groups were compared,and factors affecting the failure of PFNA internal fixation were determined by univariate logistic regression analysis and multivariate logistic regression analysis.Results There was no statistically significant difference between the two groups in gender,age and the distance between the vertices of intramedullary nails(P>0.05).The results of multivariate logistic regression analysis showed that obesity,basic diseases,degree of osteoporosis,fracture classification,fracture reduction status,and apex distance may be risk factors for failure of internal fixation of PFNA in patients with antitrochanteric fractures(P<0.05).Conclusion The factors influencing the failure of internal fixation of PFNA in antitrochanteric fractures of femur include obesity,basic diseases,severe osteoporosis,too thin lateral wall,unstable fracture,poor reduction of fracture,and too large apex distance.

关 键 词：股骨反转子间骨折 PFAN内固定术 影响因素 

分 类 号：R683.42[医药卫生—骨科学]