当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2015年
13期
35-36
,共2页
髋骨骨折%骨折内固定术%内固定器%股骨近端螺旋刀片抗旋髓内钉
髖骨骨摺%骨摺內固定術%內固定器%股骨近耑螺鏇刀片抗鏇髓內釘
관골골절%골절내고정술%내고정기%고골근단라선도편항선수내정
Hip fracture%Fracture ifxation%Internal ifxators%PFNA
目的 探讨应用股骨近端螺旋刀片抗旋髓内钉(proximal femoral nail antirotation blade,PFNA)治疗不稳定老年股骨转子间骨折的临床疗效.方法 选取应用PFNA治疗的老年股骨转子间不稳定骨折患者36例(男20例,女16例),平均年龄(72.3±4.2)岁.术后6h开始指导患者在平卧位进行股四头肌等长收缩训练和关节活动,2~3周开始部分负重.所有患者术后常规给予低分子肝素抗凝治疗3~7d.结果 本组患者均获得18个月随访,骨折愈合时间5~9个月,平均(7.6±2.4)个月.末次随访时Harris髋关节功能评分为78~95分,平均(90.2±5.6)分,优良率为94.4%(34/36),2例患者术后发生髋内翻畸形.结论 应用PFNA治疗不稳定性转子间骨折虽然可能出现术后髋内翻等并发症,但只要提高手术复位技巧,减少医源性损伤,术后及早进行功能锻炼,适当延长卧床时间,规范抗凝治疗,仍能取得相对满意的结果.
目的 探討應用股骨近耑螺鏇刀片抗鏇髓內釘(proximal femoral nail antirotation blade,PFNA)治療不穩定老年股骨轉子間骨摺的臨床療效.方法 選取應用PFNA治療的老年股骨轉子間不穩定骨摺患者36例(男20例,女16例),平均年齡(72.3±4.2)歲.術後6h開始指導患者在平臥位進行股四頭肌等長收縮訓練和關節活動,2~3週開始部分負重.所有患者術後常規給予低分子肝素抗凝治療3~7d.結果 本組患者均穫得18箇月隨訪,骨摺愈閤時間5~9箇月,平均(7.6±2.4)箇月.末次隨訪時Harris髖關節功能評分為78~95分,平均(90.2±5.6)分,優良率為94.4%(34/36),2例患者術後髮生髖內翻畸形.結論 應用PFNA治療不穩定性轉子間骨摺雖然可能齣現術後髖內翻等併髮癥,但隻要提高手術複位技巧,減少醫源性損傷,術後及早進行功能鍛煉,適噹延長臥床時間,規範抗凝治療,仍能取得相對滿意的結果.
목적 탐토응용고골근단라선도편항선수내정(proximal femoral nail antirotation blade,PFNA)치료불은정노년고골전자간골절적림상료효.방법 선취응용PFNA치료적노년고골전자간불은정골절환자36례(남20례,녀16례),평균년령(72.3±4.2)세.술후6h개시지도환자재평와위진행고사두기등장수축훈련화관절활동,2~3주개시부분부중.소유환자술후상규급여저분자간소항응치료3~7d.결과 본조환자균획득18개월수방,골절유합시간5~9개월,평균(7.6±2.4)개월.말차수방시Harris관관절공능평분위78~95분,평균(90.2±5.6)분,우량솔위94.4%(34/36),2례환자술후발생관내번기형.결론 응용PFNA치료불은정성전자간골절수연가능출현술후관내번등병발증,단지요제고수술복위기교,감소의원성손상,술후급조진행공능단련,괄당연장와상시간,규범항응치료,잉능취득상대만의적결과.
Objective To investigate the application PFNA treatment of unstable senile intertrochanteric fracture clinical efifcacy.Methods Select PFNA treatment in elderly patients with unstable fracture between the femur rotor 36 cases (male 20 cases, female 16 cases), the average age of (72.3 + 4.2) years old.. After 6h began to guide the patient in the supine quadriceps isometric contraction training and joint activities,2 to 3 weeks after the beginning of load. All patients routinely given low molecular weight heparin therapy 3-7days.Results The patients have received 18 months of follow-up, fracture healing time is 5 to 9 months, with an average of(7.6±2.4) months. Last follow-up Harris hip score of 78 - 95 points, an average of (90.2±5.6) points,excellent rate was 94.4% (34/36),2 patients the incidence of hip varus deformity.Conclusion The application PFNA treatment of unstable intertrochanteric fractures may appear postoperative hip varus complications, but as long as the to improve surgical reset skills, reduce iatrogenic injury, postoperative functional exercise early, appropriate to extend the time in bed, norms of anticoagulation treatment, was able to achieve relatively satisifed with the results.
