CAJ | 학술논문

目的：探讨闭合复位防旋型股骨近端髓内钉(Proximal femoral nail antirotation，PFNA)内固定治疗高龄股骨粗隆间骨折的临床疗效。方法：选取2011年9月-2013年9月笔者所在医院采用闭合复位PFNA内固定治疗股骨粗隆间骨折23例。按Evans分型，Ⅰ型1例，Ⅱ型2例，Ⅲ型12例，Ⅳ型8例。闭合复位，经皮置入PFNA。结果：手术时间(45.83±12.41)min。术中出血量(89.57±42.37)ml。23例均获得随访，随访时间8~17个月，平均14.6个月。均获得骨折愈合，且未发现螺旋刀片切割及退出、髋内翻畸形、术后感染等并发症。疗效依照Kuderna改良Merle D Aubigne标准评估，优15例，良7例，可1例，优良率95.65%。结论：PFNA具有微创、操作简单、手术时间短、出血量少、固定可靠、愈合率高等特点，尤其适用于老年骨质疏松患者，是治疗高龄股骨粗隆间骨折患者理想的内固定物。
목적：탐토폐합복위방선형고골근단수내정(Proximal femoral nail antirotation，PFNA)내고정치료고령고골조륭간골절적림상료효。방법：선취2011년9월-2013년9월필자소재의원채용폐합복위PFNA내고정치료고골조륭간골절23례。안Evans분형，Ⅰ형1례，Ⅱ형2례，Ⅲ형12례，Ⅳ형8례。폐합복위，경피치입PFNA。결과：수술시간(45.83±12.41)min。술중출혈량(89.57±42.37)ml。23례균획득수방，수방시간8~17개월，평균14.6개월。균획득골절유합，차미발현라선도편절할급퇴출、관내번기형、술후감염등병발증。료효의조Kuderna개량Merle D Aubigne표준평고，우15례，량7례，가1례，우량솔95.65%。결론：PFNA구유미창、조작간단、수술시간단、출혈량소、고정가고、유합솔고등특점，우기괄용우노년골질소송환자，시치료고령고골조륭간골절환자이상적내고정물。
Objective:To investigate the clinical effects of closed reduction and internal fixation with PFNA for elderly patients with femoral intertrochanteric fracture. Method:From September 2011 to September 2013,23 patients with femoral intertrochanteric fractures were treated with closed reduction and interna1 fixation with PFNA. According to Evans classification,one case was type I ,2 cases were typeⅡ,12 cases were typeⅢand 8 cases were typeⅣ. Result:The mean operating time was (45.83±12.41)min. The mean intraoperative bleeding volume was (89.57±42.37)ml.23 patients were followed up for average 14.6 months(8 to 17 months).Bone union was achieved in all cases.There were no infection,lag screw cut-out,femora1 head necrosis,varus deformity or other complications. The data was evaluated with Merle D’Aubigne scale system,5 patients were graded as excellent,7 were good,and one was fair.The excellent and good rate was 95.65%.Conclusion:It is a reliable and ideal method to treat intertrochanteric fractures with PFNA in elderly patients,because the procedure is convenient and less invasive,resulting in firm fixation,less blood loss,short operation time,and high healing rate.