PFNA微创治疗老年股骨粗隆间骨折62例

目的探讨防旋型股骨近端髓内钉（PFNA）治疗老年股骨粗隆间骨折的临床疗效。方法2005年3月至2009年6月，采用PFNA治疗老年股骨粗隆间骨折62例（Ⅰ型5例，Ⅱ型12例，Ⅲ型25例，Ⅳ型13例，Ⅴ型7例），均为闭合性骨折。观察手术并发症、骨折愈合与功能恢复情况。结果手术时间45～95min，平均58．6min；术中出血量60-260ml，平均150m1；术后随访6～36个月，平均9个月，所有骨折均愈合。根据Merled Aubigne和postel髋关节功能评分，优39例、良20例、中3例，优良率95．2％。结论PFNA治疗老年股骨粗隆间骨折，具有创伤小、失血少、内固定可靠、恢复快、并发症少的特点，特别对老年骨折疏松性骨折，具有突出的优点。

Treatment for femoral intertrochanteric fracture of elderly patients with proximal femoral nail anti-rotation

Objective To explore the clinical efficacy of femoral intertrochanterie fracture of the senile patients treated with the proximal femoral nail anti-rotation （PFNA）. Methds From March 2005 to June 2009, 62 consecutive patients with femoral intertrochanteric fracture were treated with PFNA. According to Evans classification, five cases of the fracture were type Ⅰ , 12 cases were typeⅡ , 25 cases were type Ⅲ , 13 cases were type Ⅳ and seven eases were type Ⅴ. We observed the surgical complications, fracture healing and functional recovery of the treatment. Results The mean operative time was 58.6 min （45-95 rain）, The mean blood loss was 150 ml （60-260 ml）. The mean follow-up was nine months （6-36 months）. Fracture union occurred in all patients. According to Merled＇ Aubigne-Postel score, there were excellent 39 cases, good in 20 cases, three cases; excellent rate of 95.2%. Conclusion Using PFNA treat intertrochanteric fracture of femur in the elderly with characteristics of less trauma, less blood loss, internal fixation reliably, quick recovery and less complications, especially for the elderly fracture osteoporosis fractures with outstanding advantages.