PFN治疗股骨粗隆间骨折46例分析

目的评价应用AO股骨近端髓内钉(Proximal femoral nail,PFN)治疗股骨粗隆间骨折的临床疗效。方法2003年2月至2008年8月,采用AO股骨近端髓内钉闭合复位内固定治疗46例股骨粗隆间骨折患者,评价其骨折愈合情况和并发症及优点。结果44例获随访患者经6～24个月(平均13.5个月)随访,所有患者均获得骨性愈合。术后骨折延迟愈合伴防旋髋螺钉切出1例、髋内翻1例、股骨颈螺钉松出2例。根据Harris髋关节评分,优良率达93.2%。结论PFN闭合复位内固定治疗股骨粗隆间骨折,具有手术创伤小、固定可靠、应力分布分散、适合早期功能锻炼、愈合效果好等优点,是股骨粗隆间骨折较理想的内固定物。

Treatment of Femoral Intertrochanteric Fractures by Using Proximal Femoral Nailing in 46 Cases

Objective To investigate the operative procedure and the therapeutic effects of femoral intertrochanteric fracture by using proximal femoral nailing （PFN）. Methods Forty six patients with femoral intertrochanterie fractures were treated from February 2007 to August 2008. All of cases were underwent internal fixation of PFN. Results All patients were followed up from 6 months to 24 months, with an average of 13.5 months. The X-ray films at follow-up showed that bony healing was achieved including 1 case of delayed-union followed with anti-rotation screw cutting out, 1 case of malunion and 2 cases of sliding out with lag screw. According to the Harris criterion, the excellent rate of hip function was 93.2%. Conclusion The proximal femoral nail in treatment of femoral intertrochanteric fractures can provide counteraction of rotation, promote fixation stability, enhance fracture healing facilitate early rehabilitation and decrease complication.