CAJ | 학술논문

目的探讨应用股骨近端抗旋髓内钉(PFNA)内固定治疗股骨转子下骨折的方法及疗效.方法 31例股骨转子下骨折,男14例,女17例;年龄34～90岁,平均54.6岁.骨折按Seinsheimer分型:Ⅱ型14例(ⅡA型4例,ⅡB型7例、ⅡC型3例),Ⅲ型12例(ⅢA型8例、ⅢB型4例),Ⅳ型2例,Ⅴ型3例.26例行闭合复位,5例闭合复位困难置入主钉前行骨折端切开复位.结果手术时间45～120 min,平均72.5 min.术中出血量为100～350 ml,平均127.5 ml.本组27例(87%)获得随访,随访时间8～24个月,平均14.3个月,骨折均全部愈合,骨折愈合时间10～21周,平均17.4周.按Harris髋关节功能评分标准,优21例,良2例,中4例,功能优良率为85%.结论 PFNA是一种治疗股骨转子下骨折有效的装置,符合生物力学的要求,手术创伤小,可达到较高的骨愈合率和低并发症发生率.
목적 탐토응용고골근단항선수내정(PFNA)내고정치료고골전자하골절적방법급료효.방법 31례고골전자하골절,남14례,녀17례;년령34～90세,평균54.6세.골절안Seinsheimer분형:Ⅱ형14례(ⅡA형4례,ⅡB형7례、ⅡC형3례),Ⅲ형12례(ⅢA형8례、ⅢB형4례),Ⅳ형2례,Ⅴ형3례.26례행폐합복위,5례폐합복위곤난치입주정전행골절단절개복위.결과 수술시간45～120 min,평균72.5 min.술중출혈량위100～350 ml,평균127.5 ml.본조27례(87%)획득수방,수방시간8～24개월,평균14.3개월,골절균전부유합,골절유합시간10～21주,평균17.4주.안Harris관관절공능평분표준,우21례,량2례,중4례,공능우량솔위85%.결론 PFNA시일충치료고골전자하골절유효적장치,부합생물역학적요구,수술창상소,가체도교고적골유합솔화저병발증발생솔.
Objective To evaluate the clinical outcome of new proximal femoral nail antirotation (PFNA) in treatment of subtrochanteric fractures. Methods There were 31 patients with traumatic subtrochanteric fractures intramedullarily fixed with PFNA. The patients included 14 males and 17 fe-males at a mean age of 54.6 years (range 34-90 years). According to Seinsheimer classification of sub-trochanteric fractures, 14 patients were with type Ⅱ fractures (including four patients with type ⅡA,seven with type ⅡB and three with type ⅡC), 12 with type Ⅲ fractures (including eight with type ⅢA and four with type ⅢB), two with type Ⅳ fractures and three with type Ⅴ fractures. Close reduction was performed under traction and C-arm fluoroscopy in 26 patients and open reduction through a mini-incision before inserting the nail in five patients due to difficult close reduction. Results The operation lasted for a mean time of 72.5 minutes (range 45-120 minutes), with mean blood loss of 127.5 ml (range 100-350 ml). Of all, 27 patients (87.1%, 27/31) were followed up for a mean duration of 14.3 months (range 8-24 months), which showed fracture union in all patients, with a mean union period of 17.4 weeks (range 10-21 weeks). According to Harris Hip Rate Scale, the results were. excellent in 21 pa-tients, good in two and fair in four, with excellence rate of 85.2% (23/27). Conclusions PFNA is an effective device for treatment of subtrochanteric fracture, with a high union rate and a low complication rate, for it has advantages of easy use and minor trauma, low bleeding and stable fixation in operation.