CAJ | 학술논문

目的探讨股骨近端抗旋髓内钉（PFNA）治疗老年股骨粗隆间骨折的临床效果及并发症。方法将我院收治的老年股骨粗隆间骨折患者48例作为临床研究对象，随机分为治疗组和对照组，各24例，治疗组给予PFNA手术治疗，对照组给予DHS治疗，观察两组患者的手术时间、术中出血量、术后并发症、骨折愈合时间等，统计关节功能评分情况。结果两组手术时间、术中出血量比较，差异具有统计学意义（P＜0.01）；所有患者随访中均未出现下肢深静脉血栓、感染、断钉、螺旋刀片切割股骨头等，术后出现低血容量性休克1例，出现髋内翻短缩畸形2例，所有患者骨折均愈合，平均愈合时间14周。髋关节功能评分比较，治疗组优良率明显高于对照组，差异具有统计学意义（P＜0.05）。结论老年股骨粗隆间骨折应用PFNA治疗，固定强度高、创伤小、生物力学特性好，但是临床应用中应注意围手术期隐性失血量。
목적탐토고골근단항선수내정（PFNA）치료노년고골조륭간골절적림상효과급병발증。방법장아원수치적노년고골조륭간골절환자48례작위림상연구대상，수궤분위치료조화대조조，각24례，치료조급여PFNA수술치료，대조조급여DHS치료，관찰량조환자적수술시간、술중출혈량、술후병발증、골절유합시간등，통계관절공능평분정황。결과량조수술시간、술중출혈량비교，차이구유통계학의의（P＜0.01）；소유환자수방중균미출현하지심정맥혈전、감염、단정、라선도편절할고골두등，술후출현저혈용량성휴극1례，출현관내번단축기형2례，소유환자골절균유합，평균유합시간14주。관관절공능평분비교，치료조우량솔명현고우대조조，차이구유통계학의의（P＜0.05）。결론노년고골조륭간골절응용PFNA치료，고정강도고、창상소、생물역학특성호，단시림상응용중응주의위수술기은성실혈량。
Objective To sum up the clinical effect and complications in curing femoral intertrochanteric fracture with proximal femoral nail anti-rotation(PFNA,for short). Methods 24 cases of femoral intertrochanteric fracture undergone PFNA treatment were retrospectively analyzed. Operation time, blood loss, postoperative complications and time of fracture union et al were observed and statistic data of joint function scores was made. Results Mean operating time was 76 minutes and mean bleeding volume during operation was 84.7mL.Deep venous thrombosis, infection, breaking nail and incising head of femur with helical cutting edges et al.appeared in no patients.1 case of hypovolemic shock after the operation and 2 cases of shortening deformity of coxa vara appeared.All got bony healing and the average healing time was 14 weeks.The hip-joint function scores showed that results were excellence in 18 cases,good in 4 cases,medium in 1case,and poor in 1 case. Conclusion PFNA had some advantages in treatments of femoral intertrochanteric fracture,such as seniors high fixation strength, slight injury and good biomechanical characteristics,but the hidden blood loss needed to be paid more attentionduring the perioperative period in the clinical application.