股骨近端抗旋髓内钉内固定治疗不稳定性股骨粗隆间骨折及粗隆下骨折

目的评价股骨近端抗旋髓内钉（PFNA）内固定治疗不稳定性股骨粗隆间骨折及粗隆下骨折的疗效及并发症。方法自2007年12月至2009年3月，采用PFNA内固定治疗不稳定性股骨粗隆间骨折及粗隆下骨折患者37例。结果平均手术时间48士11min，术中平均出血量70±15ml。所有病例获随访6～13个月，平均8个月。全部患者术后4．5个月内（平均3个月）达到临床骨折愈合标准，无骨折不愈合、内固定松动断裂及术后感染病例。按Harris髋关节功能评分，优24例，良10例，可3例，优良率为91．9％。结论PFNA内固定技术治疗不稳定性股骨粗隆间骨折及粗隆下骨折安全可靠，简便实用，疗效满意。

Treatment of unstable femoral intertrochanteric and subtrochanteric fractures with proximal femoral nail antirotation

Objective To evaluate the effect and complications of treatment for unstable femoral intertrochanteric and subtrochanteric fractures with proximal femoral nail antirotation（PFNA）. Method Between December 2007 and March 2009, 37 patients with unstable femoral intertroehanteric and subtrochanteric fractures were treated with PFNA. Results The mean operation time was 48 ±11 min, and the mean estimate blood loss was 70 ± 15 ml. All cases had follow up between 6-13 months, with an average of 8 months. Bone union occurred in all patients at an average of 3 months （within 4.5 months） postoperatively without complications of nonunion, loosening or breakage of prosthesis, and postoperative infection. According to Harris hip function scores, the result was excellent in 24, good in 10, fair in 3, with an excellent-to-good rate of 91.9%. Conclusion PFNA is an effective, safe and practical method for unstable femoral intertrochanteric and subtroehanteric fractures.