加长型股骨近端抗旋髓内钉治疗老年股骨反转子间骨折

发布时间：2017-12-27 00:24

本文关键词：加长型股骨近端抗旋髓内钉治疗老年股骨反转子间骨折　出处：《中国中医骨伤科杂志》2016年12期 　论文类型：期刊论文

【摘要】：目的:探讨加长型股骨近端抗旋髓内钉(PFNA)内固定治疗股骨反转子间骨折疗效。方法:回顾2013年12月至2015年12月收治的股骨反转子间骨折25例:其中男9例,女16例;年龄55~76岁,平均57.5岁。受伤原因:摔伤14例,交通伤11例,均为闭合骨折。外伤致手术时间2~5d,平均2.7d.根椐AO分型:31-A3.1型6例,A3.2型4例,A3.3型15例。均行闭合复位加长PFNA内固定术,术后即行膝髋关节功能锻炼。结果:所有患者切口均I期愈合,本组手术时间35~75min,平均(55±5)min;术中出血量为100~300 mL,平均120.5 mL.全部患者均获随访,平均随访时间7.3(4~12)个月,骨折愈合时间4~8个月,平均5.5个月,无下肢深静脉血栓、髋内翻畸形及内固定失效发生。按Harris髋关节功能评分标准:优20例,良3例,中2例,功能优良率为92.0%.结论:加长型PFNA是治疗老年股骨反转子间骨折有效的内固定方式,力臂小,更符合生物力学固定的要求,闭合复位创伤小,骨折愈合快,并发症少。
[Abstract]:Objective: To investigate the treatment of intertrochanteric fracture of the femur by the internal fixation of the proximal femoral nail (PFNA). Methods: 25 cases of intertrochanteric fracture of femur from December 2013 to December 2015 were reviewed, including 9 males and 16 females, aged 55~76 years, with an average of 57.5 years old. The cause of injury: 14 cases of injuries and 11 cases of traffic injuries, all of them were closed fractures. Trauma operation time 2~5d, average 2.7d. according to AO classification: type 31-A3.1 6 cases, A3.2 4 cases, 15 cases of type A3.3. The closed reduction and lengthening PFNA internal fixation were performed, and the knee and hip joint functional exercises were performed immediately after the operation. Results: all patients had stage I incision healing, the operative time was 35~75min, the average (55 + 5) min; intraoperative blood loss was 100~300 mL, average 120.5 mL. all patients were followed up, the mean follow-up time was 7.3 (4~12) months, fracture healing time was 4~8 months, average 5.5 months, no deep vein thrombosis, hip varus and internal fixation failure. By Harris hip score: excellent in 20 cases, good in 3 cases, in 2 cases, the excellent rate was 92.0%. conclusion: the function of PFNA is lengthened for treatment of femoral intertrochanteric fracture - effective internal fixation, small arm, more in line with the requirements of the biomechanical fixation, closed reduction and small trauma, fracture healing, complications less.
【作者单位】：沈阳医学院附属中心医院骨科;
【分类号】：R687.32
【正文快照】： 随着人口老龄化,骨质条件变差,老年人常因轻微暴力形成股骨转子间骨折,AO分型中的31-A3型骨折为股骨反转子间骨折(Reverse Oblique Intertrochanteric Femoral Fracture),因其骨折线走行方向和生物力学特征完全有别于大多数粗隆间骨折,骨折断端极不稳定,复位及内固定困难[1],

【相似文献】