闭合复位股骨近端髓内钉治疗股骨粗隆间骨折

目的 探讨应用闭合复位PFN治疗股骨粗隆间骨折的疗效.方法 自2004年12月～2007年1月对28例股骨粗隆间骨折采用闭合复位PFN治疗,对其骨折类型、合并症及临床疗效进行分析比较.结果 经随访6～15个月,骨折全部愈合,平均愈合时间4.5个月.髋关节功能优25例,占89.3%.结论 闭合复位PFN治疗股骨粗隆间骨折具有创伤小、固定牢靠、手术时间短的优点,是治疗股骨粗隆间骨折的良好选择,适用于各种类型的股骨粗隆间骨折.     

股骨近端带锁髓内钉在股骨粗隆间骨折的应用

目的探讨应用股骨近端带锁髓内钉(PFN)治疗股骨粗隆间骨折的疗效。方法应用PFN治疗股骨粗隆间骨折123例。结果所有患者均获随访,时间6～34个月,平均20个月。复查X线片显示骨折均愈合,平均愈合时间3.5个月。结论PFN治疗股骨粗隆间骨折具有手术创伤小、固定可靠、并发症少等特点,是目前治疗股骨粗隆间骨折较理想的内固定物。     

PFN内固定治疗股骨粗隆间骨折临床分析

目的分析股骨近端交锁髓内钉(PFN)内固定治疗股骨粗隆间骨折的临床应用效果。方法先对患者进行骨折复位治疗,当复位满意后再进行PFN内固定治疗。结果骨折愈合时间为(4.5±1.5)个月。根据Harris评分标准:优17例、良9例、可1例、差1例。结论采用PFN内固定治疗股骨粗隆间骨折具有固定牢固、创伤小等优点。     

老年股骨粗隆间骨折手术治疗分析

目的比较老年股骨粗隆间骨折手术治疗效果及内固定物的选择。方法采用DHS、骨端钢板、PFN三种内固定治疗股骨粗隆间骨折。结果用DHS治疗42例，骨端钢板治疗14例，PFN治疗33例。术后随访8～21个月，优良率分别为：DHS92％，骨端钢板95．2％，PFN94．3％，疗效满意。结论老年股骨粗隆间骨折应该尽早手术治疗，依据骨折类型、医院条件、医师熟练术式选择内固定物，均能取得满意疗效。     

DHS和PFN在老年股骨粗隆间骨折中的治疗选择

目的探讨DHS和PFN在老年股骨粗隆间骨折中的治疗选择和临床疗效。方法对61例老年股骨粗隆间骨折行手术治疗，其中DHS固定16例，PFN固定45例。比较两组术中和术后多项相关指标并行统计学分析。结果术后1～2年的随访，与内固定相关并发症DHS组1例，PFN组1例。两组的平均手术时间、术中失血量和术后引流量有显著统计学差异。术后3～5个月骨折均愈合，髋关节无疼痛且功能恢复良好。结论根据股骨粗隆间骨折的类型以及股骨近端的解剖结构，合理选择内固定，DHS和PFN治疗老年股骨粗隆间骨折可以获得相同良好的临床效果，但PFN手术创伤较小，更适用于高龄患者。     

股骨近端交锁髓内钉治疗股骨粗隆间骨折

目的探讨股骨近端交锁髓内钉(PFN)治疗股骨粗隆间骨折的疗效。方法行PFN内固定手术治疗股骨粗隆间骨折73例。结果本组受到6～20个月的随访,无骨愈合不良或者髋内翻,无内固定松动或折断。按照王福权等髋关节功能标准评定,本组病例优良率达100%。结论PFN手术操作简单、用时短、出血量少、固定可靠、患者术后恢复好,是治疗股骨粗隆间骨折较为理想的方法。     

股骨近端髓内钉（PFN）治疗股骨粗隆间骨折

目的探讨股骨近端髓内钉（PFN）在治疗股骨粗隆间骨折的临床疗效。方法应用PFN髓内钉治疗股骨粗隆间骨折53例,进行随访并评价其骨折愈合时间、关节功能、并发症等。结果所有患者随访6～24个月,骨折全部愈合,骨折临床愈合时间平均为12.7周。2例股骨颈部螺钉退出,无主钉或锁钉断裂,无肢体短缩或明显功能障碍。结论 PFN是治疗股骨粗隆间骨折的一种理想、可靠的内固定方法,其疗效满意,并发症少。     

老年性股骨粗隆间骨折两种手术方法疗效分析

目的探讨DHS螺钉内固定手术和人工全髋关节置换术治疗老年性股骨粗隆间骨折的临床疗效。方法采用DHS螺钉内固定手术和全髋关节置换术两种手术方法对我院101例老年性股骨粗隆间骨折患者进行治疗，并对其治疗效果、手术时间、术中出血、输血量进行评价。结果平均随访时间为19．2个月。DHS内固定组56例，优良率92．86％，全髋关节置换组45例，优良率57．78％。DHS内固定组在手术时间、术中平均出血量、术中平均输血量均显著优于全髋关节置换治疗组，P〈0．05。结论对于老年性股骨粗隆间骨折DHS内固定在疗效、手术时间、术中出血量以及术中输血量方面明显优于全髋关节置换。笔者认为DHS应用于股骨粗隆间骨折具有固定牢靠、动力加压等优点，有利于骨折稳定以及进行早期的功能锻炼，其治疗效果明显优于全髋关节置换。     

DHS和PFN在老年股骨粗隆间骨折中的治疗选择

目的探讨DHS和PFN在老年股骨粗隆间骨折中的治疗选择和临床疗效。方法对61例老年股骨粗隆间骨折行手术治疗,其中DHS固定16例,PFN固定45例。比较两组术中和术后多项相关指标并行统计学分析。结果术后1~2年的随访,与内固定相关并发症DHS组1例,PFN组1例。两组的平均手术时间、术中失血量和术后引流量有显著统计学差异。术后3~5个月骨折均愈合,髋关节无疼痛且功能恢复良好。结论根据股骨粗隆间骨折的类型以及股骨近端的解剖结构,合理选择内固定,DHS和PFN治疗老年股骨粗隆间骨折可以获得相同良好的临床效果,但PFN手术创伤较小,更适用于高龄患者。     

PFN与InterTan内固定治疗股骨粗隆间骨折的比较研究

目的回顾性对比分析2种股骨近端髓内钉PFN与InterTan内固定治疗股骨粗隆间骨折的临床疗效。方法 160例股骨粗隆间骨折行PFN和InterTan内固定,其中A组(PFN内固定)78例,B组(InterTan内固定)82例,比较两组平均手术时间、术中失血量、切口长度、术中透视次数、骨折愈合时间、术后髋关节WOMAC评分。结果 B组在平均手术时间、术中出血量、切口长度、术中透视次数方面优于A组,差异有统计学意义(P<0.05);但两组平均骨折愈合时间及术后3、6、12个月髋关节WOMAC评分差异无统计学意义(P>0.05)。结论 PFN与InterTan髓内钉内固定治疗股骨粗隆间骨折术后疗效方面无明显差异,但InterTan内固定手术操作较简单、创伤较小。     

Femoral Revision with an Extensively Hydroxyapatite-Coated Femoral Component

Between December 1996 and April 2003, 26 consecutive femoral component revisions in 24 patients were performed with an extensively hydroxyapatite-coated femoral stem. Two patients were lost to follow-up, and two patients died of unrelated causes. Of the 22 femoral revisions in 20 patients, there was a 0% incidence of mechanical loosening at average follow-up of 3.2 years (2–6.3 years). The Harris Hip Score improved from 59 (36 to 83) to 95 (84 to 100) postoperatively (p < 0.001). Rate of revision was 18.2% (4.5% for sepsis, 9.1% for instability, and 4.5% for polyethelene wear). All 22 femoral components had evidence of bone ingrowth. The extensively coated hydroxyapatite stem in this series produced excellent clinical results with a low incidence of thigh pain (4.5%) and severe stress shielding (4.5%).     

Femoral pseudo-hernias

Before surgical intervention in the femoral area, doctors should be mindful of two situations in which surgery is not indicated and, in fact, may cause harm. Electronic Publication     

Femoral pseudoaneurysms

Iatrogenic pseudoaneurysms will continue to be a problem associated with arterial cannulation procedures. With the increasing trend toward minimally invasive procedures, vascular surgeons, as well as interventionalists will be performing more cannulation procedures; hence we will be more involved in the management of this complication more frequently. Treatment trends and efforts aimed at preventing iatrogenic pseudoaneurysms have evolved over the past decade. This article reviews the history and available literature on the subject, in conjunction with the experience of a center that performs over 10,000 cannulation procedures annually.     

Femoral herniorrhaphy

The percentage of recurrences following femoral herniorrhaphy is too high.My experience has borne out the conclusion of my former chief, A. J. Ochsner that the percentage of recurrences following femoral herniorrhaphy is in direct proportion to the thoroughness of the operation.In any operation for inguinal hernia there will be a certain percentage of recurrences regardless of the type of operation.A patient anticipating a femoral herniorrhaphy may be assured that he will not have a postoperative recurrence.