中国保健营养（中旬刊）
中國保健營養（中旬刊）
중국보건영양（중순간）
China Hwalth Care & nutrition
2014年
5期
2738-2739
,共2页
股骨粗隆间骨折%PFNA%内固定
股骨粗隆間骨摺%PFNA%內固定
고골조륭간골절%PFNA%내고정
Intertrochanteric fracture%Proximal femoral nail antirotation (PFNA)%Fracture fixation
目的：探讨股骨近端防旋髓内针（PFNA）治疗老年股骨粗隆间骨折的疗效。方法：我院2011年1月至2013年3月共收治并采用PFNA内固定治疗老年患者34例，其中，男性15例，女性19例，年龄在47—95岁之间，平均77.2岁。34例中有26例合并有两种或两种以上内科疾病，8例合并有一种内科疾病，骨折按AO分类标准：分31—A1型13例，31—A2型15例，31—A3型16例，均采用闭合复位，小切口切开，股骨近端防旋髓内针（PFNA）内固定手术治疗。结果：34例患者全部获得随访，随访时间为3—12个月，平均6.3个月。骨折均获得愈合，平均愈合时间为10周。术中失血约50—150毫升，平均80毫升，手术时间为60—90分钟、平均75分钟。术后切口无感染、无深部组织感染、无深静脉血栓形成、无股骨头切割、无髋内翻畸形及PFNA松动及折断。病例采用Harris评分：优：11例，良：17例，中：5例，差：1例，优良率达82.3%。其中，30例伤肢功能基本恢复至术前，4例虽能行走，但是留有肢体疼痛。结论：PFNA治疗老年人股骨粗隆间骨折，创伤小，手术时间短，术后并发症少，肢体功能恢复良好，是治疗该类疾病较为理想的选择。
目的：探討股骨近耑防鏇髓內針（PFNA）治療老年股骨粗隆間骨摺的療效。方法：我院2011年1月至2013年3月共收治併採用PFNA內固定治療老年患者34例，其中，男性15例，女性19例，年齡在47—95歲之間，平均77.2歲。34例中有26例閤併有兩種或兩種以上內科疾病，8例閤併有一種內科疾病，骨摺按AO分類標準：分31—A1型13例，31—A2型15例，31—A3型16例，均採用閉閤複位，小切口切開，股骨近耑防鏇髓內針（PFNA）內固定手術治療。結果：34例患者全部穫得隨訪，隨訪時間為3—12箇月，平均6.3箇月。骨摺均穫得愈閤，平均愈閤時間為10週。術中失血約50—150毫升，平均80毫升，手術時間為60—90分鐘、平均75分鐘。術後切口無感染、無深部組織感染、無深靜脈血栓形成、無股骨頭切割、無髖內翻畸形及PFNA鬆動及摺斷。病例採用Harris評分：優：11例，良：17例，中：5例，差：1例，優良率達82.3%。其中，30例傷肢功能基本恢複至術前，4例雖能行走，但是留有肢體疼痛。結論：PFNA治療老年人股骨粗隆間骨摺，創傷小，手術時間短，術後併髮癥少，肢體功能恢複良好，是治療該類疾病較為理想的選擇。
목적：탐토고골근단방선수내침（PFNA）치료노년고골조륭간골절적료효。방법：아원2011년1월지2013년3월공수치병채용PFNA내고정치료노년환자34례，기중，남성15례，녀성19례，년령재47—95세지간，평균77.2세。34례중유26례합병유량충혹량충이상내과질병，8례합병유일충내과질병，골절안AO분류표준：분31—A1형13례，31—A2형15례，31—A3형16례，균채용폐합복위，소절구절개，고골근단방선수내침（PFNA）내고정수술치료。결과：34례환자전부획득수방，수방시간위3—12개월，평균6.3개월。골절균획득유합，평균유합시간위10주。술중실혈약50—150호승，평균80호승，수술시간위60—90분종、평균75분종。술후절구무감염、무심부조직감염、무심정맥혈전형성、무고골두절할、무관내번기형급PFNA송동급절단。병례채용Harris평분：우：11례，량：17례，중：5례，차：1례，우량솔체82.3%。기중，30례상지공능기본회복지술전，4례수능행주，단시류유지체동통。결론：PFNA치료노년인고골조륭간골절，창상소，수술시간단，술후병발증소，지체공능회복량호，시치료해류질병교위이상적선택。
Objective: Report and discuss the outcome of surgical treatment with proximal femoral nail antirotation (PFNA) fixation of intertrochanteric fracture in the elderly patients.Method: From January 2011 to March 2013, 34 cases with comminuted intertrochanteric fractures in the elderly patients were treated with PFNA fixation. Including 15 males and 19 females ,with an average of 77.2 years old .(range,47 to 95 years old).26 cases were combined with more than two internal disease ,8 cases combined with one internal disease .According to AO classification ,13 cases were of type A1, 15 cases were of type A2, and 16 cases of type A3 .Al cases were reduced through congitudinal traction on the traction table . The PFNA was implanted though a mini ncision without exposure of the fracture sections. Result:Al the cases were fol owed up for an average of 6.3 months (range, 3 to 12 months). The fractures of al the cases were recovered, the average periods of recovered were 10 weeks. The average loss blood was 80 ml(range,50 to 150 ml).The average times of operation were 75 minutes(range, 60 to 90 minutes).There were no complications such as infection of incisional wound ,infection of deep tissues ,phlebothrombosis ,over incision or coax adducta ,loosening of nails and PFNA snap. The result was excel ent in 11 cases ,good in 17 cases ,common in 5 cases and poor in 1 case, with total excel ent rate of 82.3%.The function of affected limbs recovered in 30 cases ,3 cases could walk with feeling limbs pain,1 case couldn’t walk caused by the limbs pain.Conclusion:PFNA has advantages of lit le trauma ,shorter periods of operations ,few complications ,good function of recovering which is suitable for al kinds of intertrochanteric fractures in the elder patients.
