股骨近端防旋髓内钉治疗高龄股骨转子间骨折的疗效  

The effect of proximal femoral nail anti-rotation for treatment of senile patients with femoral intertrochanteric fracture

作　　者：李平 程娟 王伯珉[2] LI Ping;CHENG Juan;WANG Bo-min(Dept of Orthopaedics,Shanxian Dongda Hospital,Heze,Shandong 274300,China)

机构地区：[1]单县东大医院骨科,山东菏泽274300 [2]山东省立医院创伤骨科,山东济南250000

出　　处：《临床骨科杂志》2022年第5期712-715,共4页Journal of Clinical Orthopaedics

摘　　要：目的 探讨股骨近端防旋髓内钉(PFNA)治疗高龄股骨转子间骨折的临床疗效。方法 采用PFNA治疗49例高龄股骨转子间骨折。记录术中出血量、手术时间、骨折愈合时间、住院时间、术后并发症发生情况。采用Harris评分评价髋关节功能。结果 患者均获得随访,时间4~12(10.5±5.3)个月。术中出血量20~100(50.2±6.4)ml,手术时间20~80(40.1±7.8)min,住院时间5~12(5.5±1.5) d。术后16例骨折解剖复位,33例骨折功能复位。术后无关节疼痛、畸形、褥疮等并发症发生。骨折均愈合,时间12~18(14.7±1.6)周。末次随访时,髋关节Harris评分92~96(94.8±1.5)分;11例可完全负重行走,17例扶单拐行走良好,21例需在助行器保护下行走。结论 采用PFNA治疗高龄股骨转子间骨折,具有微创、术中出血量少、手术时间短和患者术后恢复快、功能良好等优点。Objective To investigate the clinical effect of proximal femoral nail anti-rotation(PFNA) in the treatment of femoral intertrochanteric fracture in the senile patients.Methods The 49 senile patients with femoral intertrochanteric fractures were treated with PFNA. The volume of intraoperative bleeding,operation time,fracture healing time,hospital stay and postoperative complications were recorded. Harris score was used to evaluate hip function.Results All patients were followed up for 4 ~ 12(10. 5 ± 5. 3) months. The volume of intraoperative bleeding was 20 ~ 100(50. 2 ± 6. 4) ml,the operation time was 20 ~ 80(40. 1 ± 7. 8) min,and the hospital stay was 5 ~ 12(5. 5 ± 1. 5) d.After operation,there were 16 cases of anatomical reduction and 33 cases of functional reduction. There were no complications such as joint pain,deformity and bedsore. All fractures healed in 12 ~ 18(14. 7 ± 1. 6) weeks. At the last follow-up,the Harris score of hip joint was 92 ~ 96(94. 8 ± 1. 5) points;11 cases could walk with full weight-bearing,17 cases walked well with single crutch,and 21 cases needed to walk under the protection of a walker.Conclusions The treatment of senile femoral intertrochanteric fracture with PFNA has the advantages of minimally invasive,less intraoperative bleeding,short operation time,fast postoperative recovery and good function.

关 键 词：股骨转子间骨折 股骨近端防旋髓内钉 高龄 

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