防旋股骨近端髓内钉对老年骨质疏松性股骨粗隆间骨折固定作用研究

目的 探讨防旋股骨近端髓内钉(proximal femoral nail anti-rotation,PFNA)对骨质疏松性股骨粗隆间骨折的固定作用.方法 2009年1月至2010年12月,采用PFNA内固定治疗43例骨质疏松性股骨粗隆间骨折患者,男14例,女29例;年龄61～89岁,平均72.5岁.按Evans-Jensen分型:Ⅱ型28例,Ⅲ型15例.结果 43例中,均无骨不连及内固定失效等并发症发生根据Harris功能评分:优14例,良21例,可6例,差2例,PFNA优良率81.4％.结论 PFNA治疗骨质疏松性股骨粗隆间骨折疗效好,具有内固定可靠、创伤小、操作简单、骨量丢失少、允许早期功能锻炼等优点,是固定骨质疏松件股骨粗隆间骨折较为理想的髓内固定系统

Effect of proximal femoral nail anti-rotation in treatment of eldly patients with osteoporotic intertrochanteric fractures

Objective To evaluate the primary effect of proximal femoral nail anti-rotation(PFNA)in treating eldly patients with osteoporotic intertrochanteric fractures.Methods Between January 2009 and December 2010,PFNA internal fixation were performed in 43 patients with osteoporotic intertrochanteric fractures of whom were 14 males and 29 females at a mean age of 72.5 years(61-89 years).According to Evans-Jensen classification,28 cases were rated as Evans Ⅱand 15 as Evans Ⅲ.Results No complications such as infection,nonunion or loosening of nails were found.According to Harris hip rate scale system,the results were excellent in 14 cases,good in 21 cases,fair in 6 cases and bad in 2.The good rate of PFNA was 81.4%.Conclusion PFNA is a good choice to treat osteoporotic intertrochanteric fractures,owing to its advantages of stable fixation,minor trauma,easy operation,minor loss of sclerotin and early exercise.