防旋股骨近端髓内钉治疗高龄股骨转子间骨折63例临床剖析.docVIP

防旋股骨近端髓内钉治疗高龄股骨转子间骨折63例临床剖析 　　[摘要] 目的 探讨股骨转子间骨折的高龄患者应用防旋型股骨近端髓内钉内固定术（PFNA）治疗的临床效果。方法 使用防旋型股骨近端髓内钉内固定术治疗高龄股骨转子间骨折63例，术后随访半年，按Harris评分标准进行评价，分析术后功能恢复及其术后并发症发生情况。结果 63例高龄股骨转子间骨折的患者的骨折均一期愈合，平均愈合时间2.6个月，Harris评分，优42例，良16例，差5例，优良率为92.1%；所有患者功能恢复良好，无内固定松动、骨不连、脱出或再骨折等并发症发生，未见严重内科并发症发生。结论 防旋型股骨近端髓内钉内固定术，手术损伤小、操作简单、并发症少、术后功能恢复快，是高龄患者股骨转子间骨折的一种理想内固定治疗方法。 　　[关键词] 股骨转子间骨折；高龄；股骨近端髓内钉内固定术；防旋型；疗效 　　[中图分类号] R683.42 [文献标识码] B [文章编号] 2095-0616（2014）04-208-03 　　Clinical analysis on proximal femoral nail anti-rotation in the treatment of 63 elderly patients with femoral intertrochanteric fracture 　　LIANG Yuanfeng 　　Department of Orthopedics，Renhe Orthopaedic Hospital，Liaoyang 111000，China 　　[Abstract] Objective To investigate the clinical effects of proximal femoral nail anti-rotation（PFNA） in the treatment of the elderly patients with femoral intertrochanteric fracture. Methods 63 elderly patients with femoral intertrochanteric fracture were treated with PFNA， and followed up for six months after the surgery. The postoperative functional recovery and postoperative complications of patients were evaluated and analyzed according to the Harris score standards. Results 63 elderly patients with femoral intertrochanteric fracture were primary healing， the average healing time was 2.6 months， there were excellent in 42 cases， good in 16 cases， poor in 5 cases according to the Harris score， and the excellent and good rate was 92.1%； All patients had good functional recovery， no internal fixation loosening， nonunion， prolapse or re-fractures and serious medical complications happened. Conclusion Proximal femoral nail anti-rotation has less surgical damage， simple operation，fewer complications， quick recovery in postoperative function， and is an ideal fixation method in elderly patients with femoral intertrochanteric fracture. 　　[Key words] Femoral intertrochanteric fracture；Elderly；Proximal femoral nail fixation；Anti-rotation type；Efficacy 　　高龄患者髋部骨折发生率较高，股骨转子间骨折是老年人髋部骨折中的常见类型，平均发病年龄在