老年股骨粗隆间骨折治疗方法探讨.docVIP

老年股骨粗隆间骨折治疗方法探讨 　　doi：10.3969/j.issn.1007-614x.2014.15.17 　　摘 要 目的：探讨股骨近端防旋髓内钉（PFNA）微创治疗老年股骨粗隆间骨折的方法以及临床疗效。方法：2009年3月-2013年2月收治老年股骨粗隆间骨折患者33例，都采用微创方法、小切口置入PFNA来治疗。患者接受手术后会有6个月的随访，根据患者髋关节功能、疼痛和关节活动度来给予疗效评价。结果：患者接受手术后切口都在一期愈合，没有出现髋内翻、延迟愈合、感染等并发症。患者的骨折愈合很快，功能恢复情况良好，随访6～18个月（平均12个月），患者的骨折全部痊愈，愈合时间11～17周，平均13.2周。根据黄公怡的评定标准：优29例、良4例，优良率达到了100%。结论：采用PFNA治疗老年股骨粗隆间骨折操作简单、固定可靠，并且能够大大缩减骨折愈合的时间，恢复患者的患肢功能。 　　关键词 老年股骨粗隆间骨折 PFNA 微创 　　Explore the treatment method of the elderly femoral intertrochanteric fractures 　　Lai Zhiyang 　　Huian County hospital in Quanzhou City，Fujian Province，362100 　　Abstract Objective：To explore proximal femoral nail anti-rotation（PFNA）minimally invasive treatment of the elderly femoral intertrochanteric fractures and its clinical effect.Methods： 33 cases of patients with elderly femoral intertrochanteric fractures were admitted from March 2009 to February 2013.All patients used minimally invasive approach and small incision into PFNA treatment.Patients had more than 6 months of follow-up after operation.Evaluate the effect According to hip joint function， pain and joint activities.Results：The incision all were primary healing after patients received the operation.There was no coxa vara，delayed union，infection and other complications.Fractures of patients quickly healed.Function recovered well，followed up for 6～18 months（average 12 months）.Fractures of patients all healed，and the healing time was 11～17 weeks，average 13.2 week.According to the evaluation standard of Huang Gongyi：excellent was 29，good was 4，the excellent and good rate reached 100%.Conclusion：PFNA in the treatment of elderly femoral intertrochanteric fractures has the characteristics of easy operation and reliable fixation.It can greatly reduce the time of fracture healing，and recover limb function of patients. 　　Key words Elderly femoral intertrochanteric fractures；PFNA；Minimally invasive 　　目前治疗老年股骨粗隆间骨折常用的治疗方法包括多枚斯氏针固定、角钢板、鹅头钉内固定、Gamma钉、Ender针、防旋股骨近端髓内钉（PFNA）、股骨近端髓内钉（PFN）、动力髓螺钉