PFNA治疗A2型股骨粗隆间骨折的临床研究

发布时间：2018-11-17 16:24

【摘要】：目的通过随访观察分析股骨近端防旋髓内钉(PFNA)治疗A2型股骨粗隆间骨折的临床疗效。方法选取2015年10月-2016年10月,就诊于我院创伤骨科选用PFNA治疗A2型股骨粗隆间骨折患者共80例进行回顾性研究。所选患者根据AO分型均为A2型骨折,均为闭合性单侧粗隆间骨折,其中男33例,女47例,年龄65~93岁之间,平均年龄74.51±9.20岁。记录每例患者的手术时间、切口长度、术中出血量、术中X线透视次数、术后患者下地时间、骨折愈合时间、术后并发症、术后Harris评分。结果80例随访患者中,4例失访,76例患者获完全随访,失访率为5%,随访时间6-18个月。平均手术时间63.75±7.75min,平均切口长度6.46±0.92cm,平均术中出血量108.62±14.64ml,术中平均X线透视次数13.45±1.74次,平均住院时间10.37±1.83天,术后患者平均下地负重时间15.04±3.27天,骨折平均临床愈合时间74.63±12.04天,根据Harris髋关节评分标准:优19例,良34例,可21例,差2例,优良率为69.74%。结论微创PFNA技术是一种治疗A2型股骨粗隆间骨折的可靠方法,其术程短、手术创伤小、固定牢靠,允许早期功能锻炼,能减少并发症发生,但术中X线暴露次数多。股骨粗隆间骨折在我区的发病率逐年增高,本次对我院使用PFNA治疗股骨粗隆间骨折随访研究,充分肯定了其临床疗效,是一种值得推广的治疗股骨粗隆间骨折的手术方法,对我区治疗股骨粗隆间骨折提供了一定的理论依据。
[Abstract]:Objective to observe and analyze the clinical effect of (PFNA) on type A 2 intertrochanteric fracture of femur. Methods from October 2015 to October 2016, 80 patients with type A2 intertrochanteric fracture were treated with PFNA in our department of trauma and orthopedics. According to AO classification, all the patients were type A2 fractures, all of them were closed unilateral intertrochanteric fractures, including 33 males and 47 females, aged between 6593 and 9.20 years, with an average age of 74.51 卤9.20 years. Time of operation, length of incision, amount of intraoperative bleeding, times of X-ray fluoroscopy, time of landing, time of fracture healing, postoperative complications and postoperative Harris score were recorded. Results of the 80 cases, 4 cases lost the visit and 76 cases were followed up completely. The lost visit rate was 5%. The follow-up time was 6 to 18 months. The average operative time was 63.75 卤7.75 min, the average incision length was 6.46 卤0.92 cm, the average intraoperative bleeding was 108.62 卤14.64 ml, the average number of X-ray fluoroscopy was 13.45 卤1.74, and the average hospital stay was 10.37 卤1.83 days. The average weight loading time was 15.04 卤3.27 days, and the average clinical healing time was 74.63 卤12.04 days. According to Harris hip scoring criteria, 19 cases were excellent, 34 cases were good, 21 cases were fair and 2 cases were poor. The excellent and good rate was 69.74%. Conclusion minimally invasive PFNA technique is a reliable method for the treatment of A2 type intertrochanteric fracture of femur. The procedure is short, the operation trauma is small, the fixation is firm, the early functional exercise is allowed, and the complication can be reduced, but the times of X-ray exposure during operation are more. The incidence of intertrochanteric fracture of femur is increasing year by year. This follow-up study on the treatment of intertrochanteric fracture with PFNA in our hospital has fully confirmed its clinical curative effect and is a kind of operative method worth popularizing in treating intertrochanteric fracture of femur. It provides a theoretical basis for the treatment of intertrochanteric fracture of femur.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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