微创股骨近端防旋髓内钉治疗股骨转子间骨折

目的 探讨股骨近端防旋髓内钉内固定术治疗股骨转子间骨折的方法和疗效. 方法 2006年1月至2007年6月,在术中C型臂X线机透视下,采用闭合手法复位、股骨近端防旋髓内钉(PFNA)内固定术治疗股骨转子间骨折52例,其中顺转子间型12例、反转子间型23例、转子下型17例,按AO分型,A1型3例,A2型32例,A3型17例.术后每月进行随访一次,根据随访时髋关节疼痛、功能及关节活动度进行Harris评分,作出疗效评定.结果 术后无感染、脂肪栓塞、深静脉血栓形成、骨折不愈合、髋内翻及旋转畸形等并发症发生,无死亡病例.52例患者全部获得6～12个月(平均10个月)的随访,骨折全部愈合,愈合时间8～11周,平均9周.Harris评分:优44例,良8例,优良率100%. 结论 PFNA内固定术治疗股骨转子间骨折优点多、并发症少,能促进骨折的愈合和患肢功能的恢复.

Minimally invasive fixation with proximal femoral anti-rotation nails for femoral intertrochanteric fractures

Objective To investigate the effects of treating femoral intertrochanteric fractures with minimally invasive fixation with proximal femoral anti-rotation nails (PFAN) . Methods From January 2006 to June 2007, 52 patients with intertrochanteric and subtrochanteric fractures were treated with closed manipulative reduction and minimally invasive fixation with PFAN. Surgery was done under the assistance of the C-arm image intensifier. There were 12 cases of syntrochanteric type, 23 cases of countertrochanteric type,and 17 cases of subtrochanteric type. According to AO classification, 3 cases were of A1 type, 32 cases of A2type, and 17 cases of A3 type. The patients were followed up once every month. The treatment effects were accessed according to Harris Score system in terms of severity of pain, range of motion and function of the joint. Results All the 52 patients were followed up for 6 to 12 months. None of them had such com-plications as infection, fat embolism, thrombus of deep vein, nonunion of the fracture, adduction of coxa, or convolute abnormity. And no one died. All of them recovered in 8 to 11 weeks, with an average of 9 weeks.The Harris score was excellent in 44 patients and good in 8. Conclusion Femoral intertrochanterie fractures can be treated with minimally invasive fixation with PFAN which renders advantages of facilitating fracture healing, promoting functional recovery and reducing complications.