| 樊政炎,彭昊,陈森,等.股骨近端防旋转髓内钉治疗老年股骨粗隆间骨折的疗效分析.骨科,2014,5(3): 147-150. |
| 股骨近端防旋转髓内钉治疗老年股骨粗隆间骨折的疗效分析 |
| PFNA technique for the treatment of intertrochanteric fractures in the elderly |
| 投稿时间：2014-04-28 |
| DOI：10.3969/j.issn.1674-8573.2014.03.006 |
| 中文关键词: 股骨骨折 老年人 骨折固定术，髓内 |
| 英文关键词: Femoral fractures Aged Fracture fixation, intramedullary |
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| 中文摘要: |
| 目的 探讨股骨近端防旋转髓内钉(proximal femoral nail anti-rotation，PFNA)治疗老年股骨粗隆间骨折的临床疗效。方法 从2009年6月至2011年6月，采用PFNA治疗老年股骨粗隆间骨折患者82例，记录手术时间、术中出血量等指标，观察骨折的愈合及并发症发生情况，利用Harris评分对患者的功能恢复进行评估。结果 手术时间35.0～70.0 min，平均（50.7±13.4） min；术中出血100.0～250.0 mL，平均（165.5±29.7）mL。随访时间为12～24个月，骨折临床愈合时间12.0~21.0周，平均（15.3±3.6）周。术后有2例患者伤口浅表感染经扩创换药治愈，无褥疮、伤口深部感染或骨髓炎发生。截至末次随访，82例患者骨折全部愈合，无内固定松动及切割现象，无颈干角变小。参照Harris疗效评定标准：优65例，良14例，可3例，优良率96.3 %。结论 PFNA 治疗股骨粗隆骨折操作简单、手术创伤小、固定可靠、并发症少，有利于患者早期负重行走，是治疗老年股骨粗隆间骨折的理想方法。 |
| 英文摘要: |
| Objective To study the clinical curative effect of proximal femoral nail anti-rotation (PFNA) for femoral intertrochanteric fracture in the elderly. Methods Eighty-two cases of elderly patients with femoral intertrochanteric fracture were treated using PFNA technique. The operation time and blood loss were recorded. The healing of the fractures was evaluated by x-ray examinations. The functional recovery of the hip was assessed by Harris score system. Results The operation time was 35.0-70.0 min (mean 50.7 min), and the intraoperative blood loss was 100.0-250.0 mL (mean 165.5 mL). All patients were followed up for 12-24 months. By the endpoint of the follow-up, the fractures of all the patients got clinical healing. No internal fixation loosening and cut-out happened during the follow-up period. There was no reduced neck stem angle. According to the Harris hip function criteria, 65 cases were excellent, 14 cases good, 3 cases moderate, and the excellent and good rate was 96.3%. Conclusion The PFNA technique has lots of advantages including simple operation, mini-invasive, reliable fixation, less complications, and is an ideal treatment for intertrochanteric fracture in the elderly. |
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