医学美学美容（中旬刊）
醫學美學美容（中旬刊）
의학미학미용（중순간）
MEDICAL AESTHETICS AND COSMETOLOGY
2013年
9期
70-71
,共2页
冯国滨%殷勇%邓伟%弋石泉%谢成%杨帆
馮國濱%慇勇%鄧偉%弋石泉%謝成%楊帆
풍국빈%은용%산위%익석천%사성%양범
粗隆间骨折%PFNA内固定术后%股骨骨折%治疗
粗隆間骨摺%PFNA內固定術後%股骨骨摺%治療
조륭간골절%PFNA내고정술후%고골골절%치료
Intertrochanteric fracture%After PFNA fixation%Femoral fracture%Treatment
目的：探讨股骨粗隆间骨折 PFNA内固定术后髓内钉远端股骨骨折的治疗。方法2011年12月-2012年6月收治的股骨粗隆间骨折 PFNA内固定术后髓内钉远端股骨骨折3例患者，1例接受原内固定 PFNA取出更换加长 PFNA内固定手术，1例接受保留PFNA内固定，行骨折切开复位锁定钢板内固定取髂骨植骨术，1例接受保留 PFNA 内固定，行骨折切开复位锁定钢板加钢丝捆扎内固定手术。结果3例患者获得13～20个月（平均15．7个月）随访，未出现内固定材料断裂、弯曲、松动脱出。3例骨折已经骨性愈合。结论股骨粗隆间骨折 PFNA内固定术后髓内钉远端股骨骨折的治疗，我们对3例患者采用了3种手术方式治疗，体会是更换加长型 PF-NA创伤小，出血少，约150ml左右，手术时间短80分钟；而采用骨折切开复位锁定钢板固定手术，创伤大，出血多，约600ml-700ml左右，手术时间长150-160分钟。3种手术治疗方式骨折均骨性愈合，医师可以依据患者情况选择治疗方式。
目的：探討股骨粗隆間骨摺 PFNA內固定術後髓內釘遠耑股骨骨摺的治療。方法2011年12月-2012年6月收治的股骨粗隆間骨摺 PFNA內固定術後髓內釘遠耑股骨骨摺3例患者，1例接受原內固定 PFNA取齣更換加長 PFNA內固定手術，1例接受保留PFNA內固定，行骨摺切開複位鎖定鋼闆內固定取髂骨植骨術，1例接受保留 PFNA 內固定，行骨摺切開複位鎖定鋼闆加鋼絲捆扎內固定手術。結果3例患者穫得13～20箇月（平均15．7箇月）隨訪，未齣現內固定材料斷裂、彎麯、鬆動脫齣。3例骨摺已經骨性愈閤。結論股骨粗隆間骨摺 PFNA內固定術後髓內釘遠耑股骨骨摺的治療，我們對3例患者採用瞭3種手術方式治療，體會是更換加長型 PF-NA創傷小，齣血少，約150ml左右，手術時間短80分鐘；而採用骨摺切開複位鎖定鋼闆固定手術，創傷大，齣血多，約600ml-700ml左右，手術時間長150-160分鐘。3種手術治療方式骨摺均骨性愈閤，醫師可以依據患者情況選擇治療方式。
목적：탐토고골조륭간골절 PFNA내고정술후수내정원단고골골절적치료。방법2011년12월-2012년6월수치적고골조륭간골절 PFNA내고정술후수내정원단고골골절3례환자，1례접수원내고정 PFNA취출경환가장 PFNA내고정수술，1례접수보류PFNA내고정，행골절절개복위쇄정강판내고정취가골식골술，1례접수보류 PFNA 내고정，행골절절개복위쇄정강판가강사곤찰내고정수술。결과3례환자획득13～20개월（평균15．7개월）수방，미출현내고정재료단렬、만곡、송동탈출。3례골절이경골성유합。결론고골조륭간골절 PFNA내고정술후수내정원단고골골절적치료，아문대3례환자채용료3충수술방식치료，체회시경환가장형 PF-NA창상소，출혈소，약150ml좌우，수술시간단80분종；이채용골절절개복위쇄정강판고정수술，창상대，출혈다，약600ml-700ml좌우，수술시간장150-160분종。3충수술치료방식골절균골성유합，의사가이의거환자정황선택치료방식。
Purpose Explore the operative procedures and clinical outcomes of treatment of femoral fractures at intramedullary nail distal after intertrochanteric fracture were fixed with PFNA .Method December 2011 to June 2012 ,3 patients had been treated .1 patient accepted fixating a-gain with longer PFNA .1 patient accepted continue to have the original internal fixation PFNA and fracture of femur were treated with open re-duction and locking plate fixation ,and bone were grafted using ilium .1 patients accepted to keep the original PFNA fixation and femoral fractures were treated with opened reduction and locking plate fixation and wire binding .Result 3 patients obtain follow -up for an average of 15 .7(range from 13 to 20)months ,It does not happen break or bending or loosening that within -fixed plate or screw or wire or intramedullary nail .3 case has obtain bony union .Conclusion Treatment for femoral fracture at distal of intramedullary nailing after Intertrochanteric fracture were fixed with PFNA ,3 patients were treated using three ways ,our experience is that :the replacement of the lengthened PFNA for treatment the fracture is minimally invasive ,less bleeding(about 150ml) ,a short time of operation .And the fracture were treated with open reduction and locking plate fixation ,there is more trauma ,much more bleeding(about 600 -700ml) ,and a long time of operation .
