CAJ | 학술논문

目的探讨应用防旋股骨近端髓内钉(PFNA)治疗老年股骨转子间骨折的方法及疗效.方法 2006年6月至2008年8月,收治41例老年股骨转子间骨折患者,Evans-Jensen分型:ⅡA型11例,ⅡB型24例,Ⅲ型6例;其中男12例,女29例;平均年龄74.3岁(67～92岁).均在C型臂X线机透视下闭合复位后采用PFNA内固定治疗,术后髋关节功能采用Harris评分. 结果所有患者均获得随访,时间6～31个月,平均17.2个月.骨折均愈合,时间 10～17周,平均12.5周.术后髋关节Harris评分:优26例,良13例,可2例,优良率为95.1%.均未出现感染、髋内翻畸形、下肢外旋及短缩畸形、螺旋刀片切割股骨头、股骨干骨折、内同定失效及延迟骨愈合等并发症. 结论 PFNA治疗老年不稳定型股骨转子间骨折符合生物学固定原则,对骨折端的血运影响和骨质破坏较小,具有操作简单、创伤小、内固定牢靠、可早期功能锻炼及术后并发症少等优点,疗效满意.
목적 탐토응용방선고골근단수내정(PFNA)치료노년고골전자간골절적방법급료효.방법 2006년6월지2008년8월,수치41례노년고골전자간골절환자,Evans-Jensen분형:ⅡA형11례,ⅡB형24례,Ⅲ형6례;기중남12례,녀29례;평균년령74.3세(67～92세).균재C형비X선궤투시하폐합복위후채용PFNA내고정치료,술후관관절공능채용Harris평분. 결과소유환자균획득수방,시간6～31개월,평균17.2개월.골절균유합,시간 10～17주,평균12.5주.술후관관절Harris평분:우26례,량13례,가2례,우량솔위95.1%.균미출현감염、관내번기형、하지외선급단축기형、라선도편절할고골두、고골간골절、내동정실효급연지골유합등병발증. 결론 PFNA치료노년불은정형고골전자간골절부합생물학고정원칙,대골절단적혈운영향화골질파배교소,구유조작간단、창상소、내고정뢰고、가조기공능단련급술후병발증소등우점,료효만의.
Objective To evaluate the clinical effects of proximal femoral nail anti-rotation (PFNA) in treating femoral intertrochanteric fractures in the aged patients. Methods Under the guidance of flu-oroscopy, closed reduction, minimally invasive incision and percutaneous PFNA fixation were applied to treat 41 old patients with femoral intertrochanteric fracture from June 2006 to August 2008 in our hospital. They were 12 males and 29 females, with an average age of 74. 3 (67 to 92 years) years. According to Evans-Jensen classi-fication, there were 11 cases of ⅡA, 24 ⅡB, and 6 Ⅲ. Postoperative hip functions were evaluated by Harris system. Results The patients were followed up for 17.2 (6 to 31) months averagely. Fracture union was achieved in all patients with a mean healing time of 12. 5 (10 to 17) weeks. The postoperative Harris score was excellent in 26 cases, good in 13 and fair in 2. The total excellent to good rate was 95.1%. No in-fection, coxa vara, external rotation or shortening deformity, cut-out, fracture of femoral shaft, internal fix-ation failure or bone nonunion occurred. Conclusion Since PFNA fixation has advantages of less inter-ference with blood circulation at the fracture ends, little osseous destruction, simple operation, limited inva-sion, less blood loss, anti-rotation, stable fixation and few postoperative complications, it is an effective treatment for femoral intcrtrochanteric fractures in senile patients.