应用PFN治疗老年人不稳定型股骨转子间骨折

目的评价应用PFN治疗老年人股骨转子间不稳定型骨折的临床疗效。方法 2007年3月—2009年2月,我们应用PFN内固定治疗老年人股骨转子间不稳定型骨折(AO:31-A2和A3型)45例,平均年龄为77.8岁(63～92岁);其中31-A2型34例,31-A3型11例。结果患者手术时间为51～172 min,平均74 min;术中出血量为50～400 ml,平均185 ml;除1例内固定失效、1例出现切口脂肪液化外,其余未发生明显并发症。随访4～12个月,平均3.6个月骨折愈合时间平均为3个月。Parker活动评分法评估,其中优33例,良9例,可3例,优良率为93.3%。结论应用PFN能有效固定老年人股骨转子间不稳定型骨折。

Application of proximal femoral nail for treatment of unstable intertrochanteric femoral fractures i~a the elderly

Objective To evaluate the clinical results of the treatment of unstable intertrochanteric femoral fractures in the elderly with proximal femoral nail （PFN） . Methods From March 2007 to February 2009, 48 cases of unstable intertro- chanteric fracture in aged 63 - 92 （mean77. 8 ） years were treated with close reduction and intramedullary fixation using PFN. According to AO/ASIF classification, 36 （80%） fractures were classified as 31-A2, and 9 （20%） as 31-A3. Results The operative duration in this series was 51 - 172 （mean 74） minutes with intraoperative blood loss of 50 -400ml （mean： 185ml） . No serious complications occurred postoperatively, except one with internal fixation failure and another with fat lique- faction of operation incisions. A follow-up of 4 - 12 months （ mean 3.6 months） revealed a mean fracture healing time of 3 months. The results were excellent in 33 cases, good in 9 cases, 3 cases; excellent rate was 93.3%. C.onclusion proximal femoral nail can effectively fix unstable intertrochanteric femoral fractures in the elderly.