微创防旋髓内钉治疗股骨干骨折并同侧股骨近端骨折

目的探讨长型股骨近端防旋髓内钉（PFNA）治疗股骨干骨折并同侧股骨近端骨折（包括股骨颈或转子间骨折）的临床疗效。方法对32例股骨干骨折并同侧股骨近端骨折患者应用长型PFNA固定治疗。结果 32例患者均获得随访,随访时间6～24个月,平均13个月,均骨性愈合,无股骨头坏死、骨不愈及内固定断裂松动。根据Harris髋关节评分及膝关节KSS评分,32例髋关节功能恢复良好,除了1例（伴同侧髌骨粉碎骨折）膝关节活动度欠佳外,其余31例膝关节功能恢复良好。髋关节功能优良率达100.0%,膝关节优良率达96.9%。结论长型PFNA使股骨干骨折并同侧股骨近端骨折通过一次手术完成,具有创伤小、失血少、固定牢固、防切割、防旋转等优点,是治疗股骨干骨折并同侧股骨近端骨折理想的内固定物。

Minimally Invasive Fixation with Proximal Femoral Nail Anti-rotation for Ipsilateral Shaft and Proximal Femoral Fractures

ObjectiveTo evaluate the clinical effects of long type of proximal femoral nail anti-rotation（PFNA） on ipsilateral shaft and proximal femoral fractures（including femoral neck fracture and intertrochanteric fracture）.Methods The ipsilateral shaft and proximal femoral fractures were stabilized with long type of PFNA in 32 patients.ResultsPatients were followed-up for an average of 13 months（range 10 to 24 months）.All fractures healed without femoral head necrosis,fracture nonunion and internal fixation rupture or loosening.According to Harris score and Knee Society score,all the 32 patients（100.0%） achieved excellent function of hip joint and 31 patients（96.9%） obtained excellent function of knee joint（except for 1 patient with ipsilateral comminuted patellar fracture）.ConclusionIpsilateral shaft and proximal femoral fractures can heal well by one operation with long type of PFNA,which has the advantages of less trauma,less blood loss,stable fixation,anti-cutting and anti-rotation.Therefore,long type of PFNA is an ideal device for the treatment of ipsilateral shaft and proximal femoral fractures.