PFNA治疗老年人股骨粗隆间骨折的临床疗效探讨.docVIP

PFNA治疗老年人股骨粗隆间骨折的临床疗效探讨 [摘要]目的 探讨股骨近端防旋髓内针（PFNA）治疗老年人股骨粗隆间骨折的疗效。方法 选取该院2013年2月―2014年5月期间采用PFNA内固定治疗股骨粗隆间骨折57例，男23例，女34例，平均年龄为78岁，年龄在52～96岁，骨折按AO分类标准：31-A1型15例，31-A2型23例，31-A3型19例，均行闭合复位，PFNA内固定治疗此类骨折。 结果 57例均得到随访，随访时间5～12月，平均7.2个月，骨折获得痊愈，平均愈合时间为9.5周。术后切口均无感染、无血栓形成，无髋内翻畸形及PFNA松动和断裂。Harris评分：优31例，良19例，中6例，差1例，优良率为87.7%。 结论 PFNA治疗老年人股骨粗隆间骨折，操作简单，创伤小，手术时间短，出血量少，下床活动早，早期功能锻炼，防旋转、切割，并发症明显减少。 [关键词] 股骨粗隆间骨折；PFNA；内固定 [中图分类号]R59 [文献标识码]A [文章编号]1674-0742（2015）04（b）-0054-02 Femoral Intertrochanteric Fracture Clinical Curative Effect Observation of PFNA in the Treatment of Elderly Patients CAO Yutao Department of Orthopedics Surgery，The Third Affiliated Hospital of Qiqihar Medical School，Qiaihar，Heilongjiang Province，161000 China [Abstract] Objective To study femoral intertrochanteric fracture of the elderly which is cured by PFNA. Methods From February 2013 to May 2014， PFNA internal fixation in the treatment of intertrochanteric fractures in 57 cases，male 23 cases ， female 34 cases， the average age was 78 years old， aged 52～96， fracture according to AO classification criteria： 31-A1 type 15 cases， 31-A2 type 23 cases， 31-A3 type 19 cases， all closed reduction， PFNA internal fixation treatment of such fracture. Results 57 cases were followed up， follow-up time were 5～12 months， average time was 7.2 months， fracture heald， average healing time was 9.5 weeks.Postoperative incision infection， thrombosis， no hip varus deformity and PFNA loose and broken.Harris score： excellent 31 cases，good 19 cases，medium 6 cases，poor 1 case， fine rate was 87.7%. Conclusion PFNA treatment of intertrochanteric fractures in elderly patients， simple operation， small trauma， shorter operation time， blood loss， early ambulation， early functional exercise，anti rotation，cutting，decrease the complications. [Key words]Intertrochanteric fractures；PFNA；Internal fixation 随着中国进入老龄化社会，老年人骨质疏松患者越来越多，而股骨粗隆间骨折是临床上常见骨折，多见于老年人，其发生率呈明显上升趋势[1]。此种骨折保守治疗容易出现卧床并发症及原有疾病加重，常导致死亡或病残，老年人股骨粗隆间骨折最大风险不是骨折本身，而是骨折后出现的并发症或并存疾病恶化所导