PFNA治疗老年不稳定性股骨转子间骨折疗效分析

目的评价防旋股骨近端髓内钉(Proximal Femoral Nail Anti-Rotation,PFNA)治疗老年不稳定性股骨转子间骨折的临床疗效。方法自2011年6月²013年6月,采用闭合复位、PFNA内固定治疗老年不稳定性股骨转子间骨折39例,男10例,女29例;年龄672013年6月,采用闭合复位、PFNA内固定治疗老年不稳定性股骨转子间骨折39例,男10例,女29例;年龄67⁹2岁,平均76.3岁。均为单侧闭合性转子间骨折,按Tronzo-Evans分型,Ⅲ型22例,Ⅳ型17例。结果手术时间5092岁,平均76.3岁。均为单侧闭合性转子间骨折,按Tronzo-Evans分型,Ⅲ型22例,Ⅳ型17例。结果手术时间50⁸5 min,平均65 min;术中出血10085 min,平均65 min;术中出血100²50 ml,平均130 ml;39例患者切口均一期愈合,1例发生下肢深静脉血栓;骨折愈合时间10250 ml,平均130 ml;39例患者切口均一期愈合,1例发生下肢深静脉血栓;骨折愈合时间10¹6 w,平均12.3 w。Harris髋关节功能评分:优29例,良6例,中4例,优良率90%。结论 PFNA内固定创伤小、操作简便、固定牢固,是治疗老年不稳定性股骨转子间骨折的有效方法。

ANALYSIS OF THE EFFECT OF PROXIMAL FEMORAL NAIL ANTI - ROTATION TO TREAT UNSTABLE INTERTROCHANTERIC FRACTURES IN THE ELDERLY

Objective To evaluate the result of proximal femoral nail anti - rotation to treat unstable intertrochanteric fractures in the elderly. Methods From June 2011 to June 2013, 39 elderly patients of unstable intertrochanteric fractures were treated with close reduction and PFNA fixation, there were 10 men and 29 women with a mean age of 76. 3 years （67 - 92 years）. All cases were unilateral and closed fractures. According to Tronzo - Evans classification,22 cases were type Ⅲ, 17 cases were type Ⅳ. Results The operation time of 39 cases was 50 - 85 min, with an average of 65 min. The volume of blood loss was 100 -250 ml with an average of 130 ml. Operative incision of 39 cases were primary healing, and 1 case of deep venous thrombosis. Time of bone union was 10 - 16 weeks, with an average of 12. 3 weeks. According to Harris hip function score system, there were 29 cases assessed as excellent, 6 cases as good and 4 cases as acceptable. Conclusion Fractures fixation with PFNA to treat unstable intertrochanteric fractures in the elderly is an effective method, with easy operation, less invasion and stable secure fixation.