实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2014年
7期
33-35,43
,共4页
股骨近端抗旋髓内钉%股骨转子间骨折%高龄
股骨近耑抗鏇髓內釘%股骨轉子間骨摺%高齡
고골근단항선수내정%고골전자간골절%고령
proximal femoral nail antirotation%intertrochanteric fractures%elderly
目的：探讨股骨近端抗旋髓内钉（PFNA）对于高龄股骨转子间骨折患者的治疗价值。方法85例高龄股骨转子间骨折患者，年龄78～93岁，平均82岁。根据Evans-Jensen股骨转子间骨折分型标准进行分型，Ⅰ型5例，Ⅱ型20例，Ⅲ型47例，Ⅳ型12例，V型1例，均为闭合性骨折。均采用PFNA微创治疗。结果1例死亡，84例患者进行随访，时间3～12个月，平均10个月。术后随访，骨折均一期愈合，愈合时间8～16周，平均12周。均未见感染、骨不愈合、褥疮及深静脉栓塞等并发症发生。参照Harris髋关节功能评价标准：优63例，良15例，中5例，差1例，死亡1例，优良率为91.7%。结论 PFNA具有操作简单、固定牢固、微创、患者可早期活动、符合生物力学固定原则等优点，尤其适用于高龄骨质疏松的股骨转子间骨折的治疗。
目的：探討股骨近耑抗鏇髓內釘（PFNA）對于高齡股骨轉子間骨摺患者的治療價值。方法85例高齡股骨轉子間骨摺患者，年齡78～93歲，平均82歲。根據Evans-Jensen股骨轉子間骨摺分型標準進行分型，Ⅰ型5例，Ⅱ型20例，Ⅲ型47例，Ⅳ型12例，V型1例，均為閉閤性骨摺。均採用PFNA微創治療。結果1例死亡，84例患者進行隨訪，時間3～12箇月，平均10箇月。術後隨訪，骨摺均一期愈閤，愈閤時間8～16週，平均12週。均未見感染、骨不愈閤、褥瘡及深靜脈栓塞等併髮癥髮生。參照Harris髖關節功能評價標準：優63例，良15例，中5例，差1例，死亡1例，優良率為91.7%。結論 PFNA具有操作簡單、固定牢固、微創、患者可早期活動、符閤生物力學固定原則等優點，尤其適用于高齡骨質疏鬆的股骨轉子間骨摺的治療。
목적：탐토고골근단항선수내정（PFNA）대우고령고골전자간골절환자적치료개치。방법85례고령고골전자간골절환자，년령78～93세，평균82세。근거Evans-Jensen고골전자간골절분형표준진행분형，Ⅰ형5례，Ⅱ형20례，Ⅲ형47례，Ⅳ형12례，V형1례，균위폐합성골절。균채용PFNA미창치료。결과1례사망，84례환자진행수방，시간3～12개월，평균10개월。술후수방，골절균일기유합，유합시간8～16주，평균12주。균미견감염、골불유합、욕창급심정맥전새등병발증발생。삼조Harris관관절공능평개표준：우63례，량15례，중5례，차1례，사망1례，우량솔위91.7%。결론 PFNA구유조작간단、고정뢰고、미창、환자가조기활동、부합생물역학고정원칙등우점，우기괄용우고령골질소송적고골전자간골절적치료。
Objective To investigate the value of proximal femoral nail antirotation (PFNA) in the treatment of intertrochanteric fractures in elderly patients. Methods Eighty-five elderly patients with closed intertrochanteric fractures (78-93 years of age, average 82 years old) were treated with PFNA. According to Evans-Jensen classification, there were 5 cases of type Ⅰ, 20 cases of type Ⅱ, 47 cases of type Ⅲ, 12 cases of type Ⅲ, and 1 case of type V. Results Among the 85 patients, 1 patient died, and 84 patients were followed up for an average of 10 months (range, 3 to 12 months). All fractures healed by first intention. The mean healing time was 12 weeks (range, 8 to 16 weeks). No patients had infection, nonunion, bedsores, deep vein thrombosis and other complications. According to the Harris hip score, results were excellent in 63 cases, good in 15, medium in 5, poor in 1,and death in 1. The excellent and good rate was 91.7%.Conclusion PFNA provides simple operation, firm fixation and minimal invasion, allows patients to exercise early, and meets biomechanical principles in the treatment of intertrochanteric fractures, especially in elderly patients with osteoporosis.
