PFNA治疗老年患者不稳定股骨转子间骨折疗效及并发症分析.docVIP

精品论文 参考文献 PFNA治疗老年患者不稳定股骨转子间骨折疗效及并发症分析 邱志杰 徐红革 王良恩 杨勇 杨斌（四川省眉山市人民医院骨科 620010） 【中图分类号】R683【文献标识码】A【文章编号】1672-5085（2012）27-0224-03 【摘要】目的 评价PFNA治疗老年患者不稳定股骨转子间骨折的疗效和并发症。方法 本组资料共有59例患者，按AO/ASIF分型A2型骨折48例，A3型11例。主要观察指标为术中情况、骨折复位质量、术后并发症及疗效。结果 骨折全部采用闭合复位内固定，51例手术操作顺利，骨折复位52例好，可7例。48例患者在术后12周骨折愈合，39例患者恢复到伤前活动水平。有8例患者术中操作中遇到问题，随访中没有螺旋刀片切割股骨颈和进入髋臼，股骨干骨折及内固定失效病例发生。结论 PFNA能够成功治疗不稳定股骨转子间骨折且并发症少，螺旋刀片能够增加在骨质疏松骨骼的锚固力和防止股骨头颈切割。 【关键词】髓内钉 股骨转子间骨折 PFNA 并发症 Evaluate the Results and complications of elderly unstable intertrochanteric fractures treated with PFNA 【Abstract】　Aim: The study was undertaken to evaluate the Results and complications of elderly unstable intertrochanteric fractures treated by PFNA.Methods: This group had 59 elderly patients which 48 fractures belonged to AO/ASIF type A2 and 11 cases belonged to A3.Primary obJectives were assessment of surgical details，quality of reduction，postoperative complications and final outcome.Results: All patients operated by close reduction and internal fixation.51 operations were completed easily.Fracture reduction was good in 52 patients and acceptable in 7 patients.48 fractures healed within 12 weeks and 39 patients regained the pre-trauma mobility.There had technique difficulty in 8 cases during operation.No PFNA blade cut out or penetrated into acetabulum and no femoral fracture or failure of PFNA was found during following up.Conclusions: Unstable intertrochanteric femoral fractures were treated successfully by PFNA with few complications.The PFNA blade appears to provide additional anchoring and prevent cut out femoral head/neck in osteoporotic bone. 【Key words】　intramedullary nail intertrochanteric femoral fracture PFNA complication 股骨转子间骨折的发病率随着社会老龄化的进展不断上升,股骨近端抗旋转髓内钉（PFNA）是在PFN基础上设计推出的新型髓内固定器，该内固定器股骨颈固定通过一个螺旋刀片构件完成，提高了抗旋转性和角度稳定性及抗切出能力[1-5]。我院2009年1月至2011年8月采用闭合复位PFNA治疗不稳定股骨转子间骨折有完整资料者59例，现汇报如下。 材料和方法 1.一般情况：共有59例闭合性不稳定股骨转子间骨折患者纳入本研究，平均年龄76.6plusmn;5.4岁，其中男性14例，女性45例，左31例