股骨近端防旋髓内钉治疗股骨转子间骨折  

Proximal femoral nail anti-rotation in the treatment of femoral intertrochanteric fractures

作　　者：房传武[1] 江华[1] 刘伟[1] 潘良春[1] 刘飞[1] 王进[1] 陶新兵[1] 殷浩[1] FANG Chuan-wu;JIANG Hua;LIU Wei;PANG Liang-chun;LIU Fei;WANG Jin;TAO Xin-bing;YIN Hao(Dept of Orthopaedics,the First People′s Hospital of Hefei,Hefei,Anhui 230061,China)

机构地区：[1]合肥市第一人民医院关节骨科,安徽合肥230061

出　　处：《临床骨科杂志》2021年第5期731-734,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨股骨近端防旋髓内钉(PFNA)治疗股骨转子间骨折的疗效。方法采用PFNA治疗23例股骨转子间骨折患者。观察术中出血量、手术时间、骨折愈合情况、术后并发症发生情况。末次随访时采用Harris评分评价髋关节功能。结果患者均获得随访,时间3~24(11.4±8.3)个月。术中出血量20~300(90.4±6.2)ml,手术时间40~150(74.6±7.3)min。15例达解剖复位,8例达功能复位。术后1例发生部分退钉,经延长卧床时间后骨折愈合。术后4~8周骨折处开始出现骨痂。术后开始部分负重时间8~12(9.3±1.2)周。骨折愈合时间12~18(14.4±1.1)周。末次随访时,Harris评分91~95(93.0±1.6)分;19例可完全负重行走,4例需扶拐下地行走。结论PFNA治疗股骨转子间骨折具有创伤小、术中出血量少、手术时间短、髋关节功能恢复好等优点,但要关注外侧壁的完整性、围手术期出血量等影响治疗效果的因素。Objective To investigate the effect of the proximal femoral nail anti-rotation(PFNA)in the treatment of intertrochanteric fracture of femur.Methods The 23 cases of femoral intertrochanteric fracture were treated with PFNA.The intraoperative blood loss,operation time,fracture healing situation and postoperative complications were observed.Harris score was used to evaluate hip function at the last follow-up.Results All patients were followed up for 3~24(11.4±8.3)months.The intraoperative blood loss was 20~300(90.4±6.2)ml,the operation time was 40~150(74.6±7.3)min.Anatomic reduction was achieved in 15 cases and functional reduction in 8 cases.One patient had partial nail withdrawal after operation,and the fracture healed after prolonging bed rest.Callus appeared at the fracture site at 4~8 weeks after operation.The starting time of partial weight-bearing was 8~12(9.3±1.2)weeks.The healing time of fracture was 12~18(14.4±1.1)weeks.At the last follow-up,the Harris score was 91~95(93.0±1.6)points;19 cases could walk with full weight-bearing and 4 cases needed to walk with crutches.Conclusions PFNA in the treatment of intertrochanteric fractures has the advantages of less trauma,less intraoperative blood loss,shorter operation time and better recovery of hip joint function,but the integrity of the lateral wall,perioperative blood loss and other factors that affect the treatment effect should be paid attetention.

关 键 词：股骨转子间骨折 股骨近端防旋髓内钉 

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