CAJ | 학술논문

背景：防旋型股骨近端髓内钉有精确的定位装置，骨折手术置入时可采用小切口闭合复位，创伤小，对骨折端血运破坏少，符合骨折治疗的“BO”理论和微创手术原则。 　　目的：回顾分析防旋型股骨近端髓内钉治疗老年患者股骨转子间骨折的临床疗效。 　　方法：共纳入48例股骨转子间骨折患者，其中男30例，女18例；年龄70-86岁，平均77.3岁；骨折AO分型，31-A1型12例，31-A2型23例，31-A3型13例。均采用闭合复位，防旋型股骨近端髓内钉置入内固定治疗。定期随访了解骨折愈合情况及内固定装置的位置，根据Harris评分评价治疗后髋关节功能。 　　结果与结论：48例均骨性愈合，平均愈合时间4.5个月。所有股骨转子间骨折均获得满意复位，防旋型股骨近端髓内钉位置满意，无内固定物松动及脱出、固定失效、股骨头缺血性坏死、髋内翻畸形等并发症发生。末次随访髋关节功能Harris评分显示，优31例，良14例，可3例，优良率为93.7%。提示防旋型股骨近端髓内钉治疗老年患者股骨转子间骨折符合生物力学要求，安全有效。
배경：방선형고골근단수내정유정학적정위장치，골절수술치입시가채용소절구폐합복위，창상소，대골절단혈운파배소，부합골절치료적“BO”이론화미창수술원칙。 　　목적：회고분석방선형고골근단수내정치료노년환자고골전자간골절적림상료효。 　　방법：공납입48례고골전자간골절환자，기중남30례，녀18례；년령70-86세，평균77.3세；골절AO분형，31-A1형12례，31-A2형23례，31-A3형13례。균채용폐합복위，방선형고골근단수내정치입내고정치료。정기수방료해골절유합정황급내고정장치적위치，근거Harris평분평개치료후관관절공능。 　　결과여결론：48례균골성유합，평균유합시간4.5개월。소유고골전자간골절균획득만의복위，방선형고골근단수내정위치만의，무내고정물송동급탈출、고정실효、고골두결혈성배사、관내번기형등병발증발생。말차수방관관절공능Harris평분현시，우31례，량14례，가3례，우량솔위93.7%。제시방선형고골근단수내정치료노년환자고골전자간골절부합생물역학요구，안전유효。
BACKGROUND:Proximal femoral nail antirotation has a precise positioning device. Smal incision closed reduction was used during implantation after fracture. This method induces few traumas and less damage to blood transportation at the fracture end, and is accorded with“BO”theory and the principle of smal invasive operation for treatment of fracture. OBJECTIVE:To retrospectively analyze the clinical therapeutic effects of proximal femoral nail antirotation for intertrochanteric fractures in senile patients. METHODS:A total of 48 patients with intertrochanteric fractures were enrol ed, including 30 males and 18 females, aged 70-86 years old, averagely 77.3 years. According to AO classification, there were 12 cases of 31-A1, 23 cases of 31-A2 and 13 cases of 31-A3. Closed reduction and proximal femoral nail antirotation were utilized. Fracture healing and the position of the device were understood by regular fol ow-up. Functional recovery of the hip joint was evaluated using Harris score after surgery. RESULTS AND CONCLUSION:Bone union was observed in 48 cases, averagely 4.5 months. Satisfactory reduction was obtained in al intertrochanteric fractures. The position of the nail was satisfactory. No complications appeared such as loosing, prolapse, ineffective fixation, avascular necrosis of the femoral head and coxa vara malformation. During final fol ow-up, Harris score revealed excellent in 31 cases, 14 in good and 3 in average, with an excellent and good rate of 93.7%. Results indicated that proximal femoral nail antirotation for intertrochanteric fractures in elderly patients was in accordance with the requirement of biomechanics, and was safe and effective.