CAJ | 학술논문

目的评估采用国际内固定研究学会(AO/ASIF)股骨近端髓内钉(PFN/PFNA)治疗股骨转子间骨折的临床疗效.方法 2008年1月至2010年12月我院采用AO/ASIF的PFNA治疗股骨转子间骨折56例,所有患者均为单侧闭合性骨折,受伤至手术时间为2.0～10.0 d,平均3.2d,术后1、2、3、6、12个月门诊随访,以后每年至少复查1次,随访时所有患者均拍摄髋关节正侧位X线片.临床疗效评估采用Harris髋关节功能评估标准.结果所有患者手术时间40～80 min,平均55 min.术中出血量50～150 ml,平均80 ml.患者均为术后3～7d下地扶拐行走.56例患者均获得完整随访,随访期间全部患者均未出现感染、下肢静脉血栓、头钉切割股骨头及断钉现象.4例出现髋内翻短缩畸形,无骨折不愈合患者.骨折愈合时间为3.5 ～6.0个月,平均4.0个月.按Harris髋关节功能评分标准:优43例,良9例,中4例,优良率92.86％ (52/56).结论 AO/ASIF的PFN(A)治疗方法具有微创、固定强度高、生物力学特性好等特点,治疗股骨转子间骨折愈合率高,功能恢复快,并发症少.
목적 평고채용국제내고정연구학회(AO/ASIF)고골근단수내정(PFN/PFNA)치료고골전자간골절적림상료효.방법 2008년1월지2010년12월아원채용AO/ASIF적PFNA치료고골전자간골절56례,소유환자균위단측폐합성골절,수상지수술시간위2.0～10.0 d,평균3.2d,술후1、2、3、6、12개월문진수방,이후매년지소복사1차,수방시소유환자균박섭관관절정측위X선편.림상료효평고채용Harris관관절공능평고표준.결과 소유환자수술시간40～80 min,평균55 min.술중출혈량50～150 ml,평균80 ml.환자균위술후3～7d하지부괴행주.56례환자균획득완정수방,수방기간전부환자균미출현감염、하지정맥혈전、두정절할고골두급단정현상.4례출현관내번단축기형,무골절불유합환자.골절유합시간위3.5 ～6.0개월,평균4.0개월.안Harris관관절공능평분표준:우43례,량9례,중4례,우량솔92.86％ (52/56).결론 AO/ASIF적PFN(A)치료방법구유미창、고정강도고、생물역학특성호등특점,치료고골전자간골절유합솔고,공능회복쾌,병발증소.
Objective To investigate the clinical outcomes of intertrochanteric fracture by the fixation using proximal femoral nail (PFN/PFNA).Methods From Jan.2008 to Dec.2010,56 cases with intertrochanteric fracture,including 18 males and 38 females with an average age of 76 years (range,67 -94 ),were treated by fixation with PFN or PFNA.All patients had closed fractures in the shaft of femur.The average time from injury to operation was 3.2 days (ranging from 2.0 days to 10.0 days).All the patients were followed for 1,2,3,6,12 month after surgery,respectively,and then at least once per year.The clinical outcomes were evaluated according to Harris criteria and radiological examinations.Results The mean operating time of all cases was 55 minutes ( ranging from 40 to 80 minutes),and the mean blood loss during surgery was 80 ml (range,50 - 150 ml).All patients was able to walk with walking aid 3 -7 days after surgery.All the patients with fracture healed after 3.5 - 6.0 months ( mean:4 months ).No complications such as infection,lower limb vein infarction,cut-out or breakage of the implants occurred.Four cases had coxa vara shortening deformation,According to Harris criteria,the clinical results were excellent in 43 cases,good in 9,and moderate in 4,with the rate of patients in excellent and good condition was 92.86％ (52/56).Conclusion PFN/PFNA is an effective and minimally invasive method for intertrochanteric fracture,with minimal invasion,high fixation-strength and optimal biomechanics characteristics.This treatment technique produces a high rate of bone re-union,early functional recovery and less complications.