【摘要】 目的 探讨闭合复位下防旋股骨近端髓内钉(PFNA)治疗老年不稳定型股骨粗隆间骨折的疗效。方法 对36例老年股骨粗隆间不稳定型骨折采用闭合复位PFNA固定，术后积极抗骨质疏松治疗，早期指导患者功能康复锻炼，出院后对患者骨折愈合情况及髋关节功能进行随访。结果 36例患者均获得随访12～18个月，平均15个月，所有患者骨折均愈合，无髋内翻畸形病例，骨折愈合时间3～7个月，平均4.1个月，末次随访患者髋关节功能Harris评分优16例，良18例，可2例。结论 闭合复位PFNA治疗老年不稳定型股骨粗隆间骨折具有创伤小，对骨折端血运破坏小，固定牢靠，防旋转及支撑能力强，促进患者早期康复等优点，是目前治疗老年不稳定型股骨粗隆间骨折行之有效的方法。更多还原

【Abstract】 Objective To explore the efficacy of closed reduction and internal fixation using proximal femoral nail antirotation(PFNA) to treat elderly patients with unstable intertrochanteric femoral fractures. Methods A total of 36 elderly patients with unstable intertrochanteric femoral fracture were subjected to closed reduction and internal fixation using PFNA. After operation, active treatment was provided to prevent osteoporosis, while early guidance about rehabilitation exercise was given for better physiological function. All patients were followed up after discharge to assess their fracture healing and hip joint function. Results All patients were followed up for 12 to 18 months, with an average of 15 months. All fractures were healed, without coax varus deformity. The fracture healing time was 3 to 7 months, with an average of 4.1 months. In the last follow-up visits, 16 patients, 18 patients and 2 patients were assessed excellence, goodness and fairness in Harris function scores, respectively. Conclusion Closed reduction and internal fixation using PFNAs can be adopted to treat elderly patients with unstable intertrochanteric fractures, with small incision and little damage to fracture-end blood supply. The approach can provide strong fixation and supporting against rotation and promotes recovery at early stage, which can be widely applied in clinical practice.更多还原