闭合复位股骨近端防旋髓内钉治疗老年股骨转子间骨折  

Treatment of elderly intertrochanteric fractures with closed reduction and proximal femoral nail anti-rotation

作　　者：张兆尧[1] 戢勇[1] ZHANG Zhao-yao;JI Yong(Section Ⅰ,Dept of Orthopaedics,the People′s Hospital of Jianyang City,Jianyang,Sichuan 641400, China)

机构地区：[1]简阳市人民医院骨一科,四川简阳641400

出　　处：《临床骨科杂志》2022年第1期97-100,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨闭合复位股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折的疗效。方法采用闭合复位PFNA治疗88例老年股骨转子间骨折患者。记录手术时间、术中出血量、骨折愈合情况以及术后并发症发生情况,采用Harris髋关节功能评分标准评定疗效。结果手术时间48~126(82.3±24.6)min,术中出血量50~280(79.4±22.6)ml。患者均获得随访,时间6~12个月。无骨折位移、内固定松动、髋内外翻、断钉等并发症发生,仅2例出现骨折延迟愈合。骨痂形成时间2~5(2.8±0.6)个月。骨折愈合时间3~6(4.5±1.2)个月。采用Harris髋关节功能评分标准评定疗效:术后2个月时优60例,良18例,差10例,优良率为88.6%;末次随访时优63例,良19例,差6例,优良率为93.2%。结论闭合复位PFNA治疗老年股骨转子间骨折疗效显著,手术时间短,术后并发症少,有助于提高患者术后恢复效果。Objective To investigate the effect of closed reduction and proximal femoral nail anti-rotation(PFNA)in the treatment of elderly femoral intertrochanteric fractures.Methods The 88 elderly patients with femoral intertrochanteric fractures were treated with closed reduction and PFNA.The operation time,intraoperative blood loss,fracture healing time and the incidence situation of postoperative complications were recorded.Harris hip function score criterion was used to evaluate the curative effect.Results The operation time ranged from 48~126(82.3±24.6)min,the intraoperative blood loss was 50~280(79.4±22.6)ml.All patients were followed up for 6~12 months.There were no complications such as fracture displacement,loosening of internal fixation,coxa vara or coxa valga,broken screw,only 2 cases had delayed union.The callus formation time was 2~5(2.8±0.6)months.The healing time of fracture was 3~6(4.5±1.2)months.The efficacy was assessed with Harris hip function score criterion,at 2 months postoperation,60 cases were excellent,18 cases good,10 poor,and the excellent-good rate was 88.6%;at the last follow-up,63 cases were excellent,19 cases were good and 6 cases poor,with the excellent-good rate of 93.2%.Conclusions Closed reduction and PFNA have significant effect in the treatment of elderly femoral intertrochanteric fracture,with shorter operation time,fewer postoperative complications,which are helpful to improve the postoperative recovery effect of patients.

关 键 词：股骨近端防旋髓内钉 闭合复位 股骨转子间骨折 

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