CAJ | 학술논문

目的探讨股骨近端抗旋髓内钉(proximal femoral nail anti-rotation PFNA)治疗老年性股骨粗隆间骨折的临床疗效.方法对闭合复位PFNA内固定治疗65岁以上老年性股骨粗隆间骨折36例患者的临床疗效进行回顾性分析.分析患者的手术时间、术中出血量、骨折复位、愈合情况及Harris评分评估患髋功能.结果所有患者均顺利接受手术治疗，获得6~18月随访，平均11个月，骨折全部一期愈合，愈合时间为3~6月.1例发生肺性脑病，无切口感染、脂肪栓塞、深静脉血栓形成(DVT)、螺旋刀片松动断裂及切割股骨头、内固定周围骨折、髋内翻畸形等并发症发生.根据按Harris髋关节功能评分：优良率88.8%.结论 PFNA具有微创操作，失血少、骨折端固定牢固、防旋转、防切割、并发症少及术后患者可早期功能锻练等优点，对于老年性股骨粗隆间骨折患者，特别是不稳定类型的，是一种较为理想的内固定方法.
목적탐토고골근단항선수내정(proximal femoral nail anti-rotation PFNA)치료노년성고골조륭간골절적림상료효.방법대폐합복위PFNA내고정치료65세이상노년성고골조륭간골절36례환자적림상료효진행회고성분석.분석환자적수술시간、술중출혈량、골절복위、유합정황급Harris평분평고환관공능.결과소유환자균순리접수수술치료，획득6~18월수방，평균11개월，골절전부일기유합，유합시간위3~6월.1례발생폐성뇌병，무절구감염、지방전새、심정맥혈전형성(DVT)、라선도편송동단렬급절할고골두、내고정주위골절、관내번기형등병발증발생.근거안Harris관관절공능평분：우량솔88.8%.결론 PFNA구유미창조작，실혈소、골절단고정뢰고、방선전、방절할、병발증소급술후환자가조기공능단련등우점，대우노년성고골조륭간골절환자，특별시불은정류형적，시일충교위이상적내고정방법.
Objective:To discuss the Proximal femoral nail anti-rotation in treatment of senile femoral intertrochanteric fracture. Methods:closed reduction and internal fixation for the treatment of PFNA patients above 65 years old of femoral intertrochanteric fractures in36 patients were retrospectively analyzed clinical curative effect. Analysis of the patients with operation time, bleeding volume in operation, reduction of the fracture, healing and Harris score assessment of hip function. Results:all patients were successfully accept retrosperation treatment, from 6 to18months, an average of 11 months, all fractures healed, the healing time of 3~6 months. In 1 cases of recurrence of the patients with operation time, bleeding volume in operation, reduction of the fracture, healing and Harris score assessment of hip function. Results: all patients were successfully accept retrosperation treatment, from 6 to18months, an average of 11 months, all fractures healed, the healing time of 3~6 months. In 1 cases of recurrence of cerebral infarction, no incision infection, fat embolism, deep venous thrombosis ( DVT ), spiral blade cutting loose and cutting femoral head fractures, internal fiation of periprosthetic fractures, complications of hip varus deformity. According to the Harris hip score: the excellent and good rate was 88.8%. Conclusion: PFNA has minimally invasive operation, less blood loss, fracture fixation, preventing rotation, cutting prevention, less complications and postoperative patients with early functional exercise and other advantages, for senile patients with intertrochanteric fractures, especially unstable type, is a kind of ideal internal fixation methods.