股骨近端骨折PFNA内固定的治疗体会

发布时间：2018-04-30 09:46

本文选题：股骨近端骨折 + 股骨粗隆间骨折　；参考：《中国矫形外科杂志》2017年22期

【摘要】：[目的]探讨应用股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)内固定治疗股骨近端(股骨粗隆间、股骨粗隆下)骨折的临床效果及治疗体会。[方法]对90例在本院治疗的股骨近端骨折患者,C臂机透视下行骨折闭合复位、PFNA内固定微创治疗。观察骨折愈合时间、并发症、髋关节功能恢复情况。[结果]手术时间20~90 min,平均40 min;术中出血量50~300 ml,平均80 ml。骨折全部愈合,无髋内翻、螺钉退出、螺旋刀切出、感染、神经血管损伤等并发症发生。髋关节功能采用Harris评分,优62例,良25例,可3例,优良率达97%。[结论]PFNA内固定微创治疗股骨近端骨折操作简单、损伤小、出血少、恢复快、并发症少,是治疗股骨近端骨折理想的治疗方法。熟练掌握骨折复位技巧及PFNA内固定手术技术,可缩短手术时间,减少手术出血量,减少X线暴露次数,对患者快速康复有重要意义。
[Abstract]:[objective] to investigate the clinical effect and treatment experience of proximal femoral nail antirotation nail in the treatment of proximal femur (intertrochanteric, subtrochanteric) fractures of the femur. [methods] A total of 90 patients with proximal femur fractures treated in our hospital were treated with closed reduction and minimally invasive treatment with PFNA internal fixation. The healing time, complications and hip function were observed. [results] the operative time was 20 ~ 90 min (mean 40 min) and the intraoperative bleeding was 50 ~ 300 ml (mean 80 ml). All fractures healed without hip varus, screw withdrawal, helical knife excision, infection, neurovascular injury and other complications. The hip joint function was assessed by Harris score, excellent in 62 cases, good in 25 cases, fair in 3 cases. The excellent and good rate was 97%. [conclusion] minimally invasive treatment of proximal femoral fractures with PFNA is an ideal method for the treatment of proximal femoral fractures with simple operation, less injury, less bleeding, quick recovery and less complications. Mastering the technique of fracture reduction and PFNA internal fixation can shorten the operation time, reduce the amount of operative bleeding and reduce the number of X-ray exposures, which is of great significance for the rapid recovery of patients.
【作者单位】：广东省佛山市中医院骨九科;
【分类号】：R687.3

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