【摘要】 目的探讨股骨近端防旋髓内钉(PFNA)内固定治疗股骨转子间骨折失败的原因及其行髋关节置换的疗效。方法 10例老年股骨转子间骨折患者经PFNA内固定治疗失败后行股骨头置换7例,全髋关节置换3例。术后12个月采用Harris评分标准评价疗效。结果 9例随访12～24个月,1例随访6个月时死亡。无切口感染、假体松动、关节脱位、假体周围骨折等并发症发生。术后12个月髋关节Harris评分72～91分,优6例,良2例,可1例。结论 PFNA内固定失败后,行股骨头置换或全髋关节置换临床疗效满意。更多还原

【Abstract】 Objective To investigate the causes of failure of proximal femoral nail anti-rotation( PFNA) in the treatment of femoral intertrochanteric fracture,and to observe the clinical effect after revision. Methods After failure of ten elderly patients with femoral intertrochanteric fractures treated with PFNA internal fixation,of which 7 cases underwent femoral head replacement,and 3 cases were performed with total hip replacement. The curative effect was evaluated by Harris score at 12 months after operation. Results Nine cases were followed up for 12 ～ 24 months and1 case died after 6 months. There were no complications such as wound infection,prosthesis loosening,joint dislocation and periprosthetic fracture. At 12 months after operation,Harris score of hip joint ranged from 72 points to 91 points,the results were excellent in 6 cases,good 2 cases and fair 1. Conclusions After failure of PFNA internal fixation,femoral head replacement or total hip arthroplasty can obtain satisfactory clinical efficacy.更多还原