防旋股骨近端髓内钉治疗股骨转子间骨折.docVIP

防旋股骨近端髓内钉治疗股骨转子间骨折【摘要】目的评价防旋股骨近端髓内钉治疗股骨转子间骨折的临床疗效。方法2009年1月至2011年1月，采用防旋股骨近端髓内钉治疗股骨转子间骨折18例，男11例，女7例：年龄23~82岁，平均66?5岁。受伤原因：步行跌伤13例，车祸伤3例，高处坠落伤2例。AO分型：A1型3例，A2型12例，A3型3例。骨折采用闭合复位，防旋股骨近端髓内钉内固定术。结果平均手术时间64 min(55~85 min)。平均失血量260 ml(150~450 ml)。术中6例须扩髓即可放入主钉， 12例无须扩髓即可放入主钉。平均部分负重时间8 d(6~23 d)。平均随访9?5个月(7~18个月)。切口均一期愈合，骨折平均5?5个月愈合(4~8个月)，术后功能均恢复到伤前水平，1例主钉入点偏外导致140内翻。结论防旋股骨近端髓内钉可以有效地固定股骨转子间骨折，手术时间短，出血少，抗旋转能力强，可早期功能锻炼，并发症少，是治疗股骨转子间不稳定性骨折的较好方法。 【关键词】股骨转子间；骨折固定术；内;内固定器 Treatment of intertrochanteric fractures fractures with the proximal femoral nail anti?rotationDONG Guo?liang, HUANG Jin?xing, HUANG Xiao?rong, et al? Department of Orthopedics, Traditional medicine Hospital of Xin Du? City, Xin?Du Sichuan, 650500,China 【Abstract】Objectiveto explore the clinical outcome of intertrochanteric fractures with the proximal femoral nail anti?rotation (PFNA)?MethodsEighteen patients for intertochanteric fractures of the femur were treated with the proximal femoral nail anti?rotation from January 2009 to January 2011 There were 11 males and 7 females with an average age of 66?5 years(ranged from 23 to 82 years)?Mechanism of injury：pedestrian injury in 13 cases，traffic accident in 3 cases and fall injury in 2 cases?AO classification:A1 type in 3 cases,A2 type in 12 cases,A3 type in 3 cases, The fractures were reducted with closed reduction technique and fixed with the proximal femoral nail anti?rotation?Results The mean operative time was 64 min (55?85 min)?The mean operative blood loss was 260 ml (150?450 ml)?Reaming in 6 cases andunreaming in 12 cases during operative procedure? The median time to partical weight?bearing was 8 d(6?23 d)?The mean duration of follow up was 9?5 months (7?18 months)?The wound healing was smoothly in 18 patients?The average time of fracture heaking was5?5 months (4?8 months)?The postoperative function was recovered to premorbid status in all patients? One patient suffered varus deformity in 140due to the lateral entrying pointof the main nail?Co