PFNA内固定治疗老年不稳定股骨粗隆间骨折

目的通过对老年不稳定股骨粗隆间不稳定骨折的患者随访，评价PFNA内固定对其治疗效果。方法对56例老年不稳定股骨粗隆间骨折采用PFNA内固定治疗，所有患者均经C型臂X线机透视下牵引、闭合复位，术中不显露骨折断端，小切口置入PFNA。结果本组随访10～26个月，平均18个月，骨折全部愈合，根据Harris评分：优42例，良12例，可2例，优良率96．4％。结论PFNA具有微创、出血量少，较容易掌握手术要领，使断端处固定可靠，符合生物力学固定原则，对老年不稳定股骨粗隆间骨折是一种良好的内固定方法。

Treatment of unstable femoral intertrochanteric fracture in elderly patients with internal fixation using PFNA

Objective To investigate the clinical effects of unstable femoral intertrochanteric fracture in elderly patients with minimally invasive fixation with and internal fixation using PFNA. Methods 56 patients wih unstable femoral intertrochanteric fractures were treated with minimally invasive and internal fixation using PFNA. Surgery was done under the assistence of the C-arm image intensifier, all cases were reduced through longitudinal traction on the traction table. The PFNA was implanted through a mini-incision without exposure of the fracture section during the operation. Results All the 56 patients were followed up for an average of 18 month （range, 10 to 26 months）. All of them recovered, according to the Harris rating system： excellent in 42 cases, good in 12 cases, fair in 2 cases, The good and excellence rates were 96.4%. Conclusion It is a reliable method to treat intertrochanteric fractures with PFNA in elderly patients, because the procedure is convenient and less invasive, less blood loss, resulting in firm fixation, Consistent with the principles of biological fixation, and other advantages.