PFNA治疗高龄骨质疏松不稳定股骨粗隆间骨折临床研究

目的探讨股骨近端防旋髓内钉（proximal femoral nail anti-rotation,PFNA）治疗高龄原发骨质疏松（primaryosteoporosis,PO）患者不稳定股骨粗隆间骨折的疗效。方法选择2008年1月～2012年5月行PFNA内固定的43例不稳定股骨粗隆间骨折设立为Ⅰ组,另选择同期行Gamma钉内固定40例设立为对照组,比较两组的术中平均手术时间、平均出血量、术后骨折平均愈合时间、术后随访不同时间Harris评分、优良率。结果Ⅰ组患者的手术时间短,术中出血少、术后骨折平均愈合时间快,Ⅰ组的Harris评分术后6个月和术后12个月均明显高于术后3个月,且分别明显高于Ⅱ组,Ⅰ组术后的优良率明显高于Ⅱ组,差异有统计学意义（P〈0.05）。结论PFNA是治疗高龄合并PO的不稳定股骨粗隆间骨折的有效方法,值得推广和应用。

PFNA for unstable intertrochanteric fracture in old people with osteoporosis

Objective To evaluate the efficacy of proximal femoral nail anti-rotation（PFNA） in the treatment of unstable intertrochanteric fractures in old people with osteoporosis.Methods From January 2008 to May 2012,the PFNA fixed line 43 cases of unstable intertrochanteric fractures established as group Ⅰ,the other 40 cases underwent gamma nail fixed established as control group,the mean operative time in the two groups of patients,the average amount of bleeding,postoperative fracture average healing time,postoperative follow-up time,Harris score,excellent rate.Results Group Ⅰ patients,surgery time was short,less blood loss,postoperative fold average healing time,Harris score of the group Ⅰ after 6 months and 12 months after surgery were significantly higher than after 3 months,and Ⅰ postoperative excellent rate was significantly higher than in group Ⅱ,there was a significant difference（P〈0.05）,respectively,significantly higher than the group Ⅱ.Conclusion PFNA is an effective implants in the treatment of unstable intertrochanteric fractures in old people with osteoporosis.