防旋型股骨近端髓内钉治疗老年股骨转子间骨折疗效分析

目的探讨防旋型股骨近端髓内钉（PFNA）治疗老年股骨转子间骨折的临床疗效。方法2010年3月至2011年6月采用PFNA治疗42例老年股骨转子间骨折。手术采用牵引床闭合复位，c形臂x线透视机透视下小切口置入PFNA内固定。结果42例患者手术时间为40-85min，平均59min；术中失血量为40-150ml，平均86．4ml。所有患者经9～16个月，平均12．4个月随访，x线片显示骨折均愈合，愈合时间为9～15周，平均12周。术后未发生感染、髋内翻畸形、螺旋刀片切出股骨头等并发症。根据髋关节Harris髋关节功能评分，优17例，良22例，可3例，差0例，优良率为92．9%。结论PFNA治疗老年股骨转子间骨折具有操作简便、手术时间短、创伤小、固定牢靠等优势，是目前治疗老年股骨转子间骨折的理想选择。

Efficacy of proximal femoral nail anti-rotation in treatment of intertrochanteric fractures in elderly

Objective To investigate the clinical efficacy in treatment of intertrochanteric fractures in elderly with proximal femoral nail anti rotation （PFNA）. Methods Forty-two elderly patients with intertrochanteric（ fractures were received the treatment of PFNA from March 2010 to June 2011. The operation were carried out on the traction table with C-arm Xray machine and minimally invasive fixed with PFNA. Results The operation time was 4085 min with average 59 min, the operation blood lose was 40-150 ml with average 86.4ml. All 42 cases were follow-up from 9-16 months with average 12. 4 months. All fractures obtained bone union range from 9-15 week. There was no complications, such as infection, malformation of hip varus, cut-out during the follow-up period. According to Harris hip score, the function of hip joint was excellent in 17 cases, good in 22 cases, and fair in 3 cases, with the excellent and good rate being 92. 9%. Conclusions PFNA has advantages of simple operation, shorter operative time, minimal invasion and reliable fixation. It is an ideal choice for the elderly with intertrochanteric fractures.