【作者】 吕信息； 薛志强； 赵滨； 田智勇； 吴西智；

【机构】 贵阳市第四人民医院骨科；

【摘要】 目的探讨PFNA治疗股骨反粗隆间骨折的临床疗效。方法回顾性分析2010年3月至2013年12月应用PFNA治疗27例股骨反粗隆间骨折资料,按AO/OTA分型:31-A3.1型4例,31-A3.2型8例,31-A3.3型15例,男15例,女12例。年龄41岁～95岁,平均68岁。左侧14例,右侧13例。致伤原因:坠落伤2例,车祸伤2例,摔伤23例。采用牵引床牵引、有限切开或闭合复位,复位后均行PFNA固定治疗。记录临床和影像学结果,根据Harris髋关节功能评分标准,评价术后髋关节功能。结果 27例骨折复位均在透视下进行,其中闭合复位17例,有限切开复位10例。平均手术时间(70.0±14.1) min,平均术中失血量(160.0±12.6) ml,平均透视次数(25±5)次。术后27例患者均获8～36个月随访,平均随访16.5个月,骨折愈合时间为4～9个月,平均愈合时间5.1个月。末次随访时髋关节功能按Harris评分标准为85～95分,平均91.2分。结论 PFNA治疗反粗隆间骨折具有操作简单,创伤小,出血少,固定牢固,手术时间短,并发症少,愈合率较高,可早期负重等优点,推荐在治疗反粗隆间骨折时优先考虑采用PFNA。更多还原

【Abstract】 Objective To evaluate the clinical effect of reverse intertrochanteric fractures using proximal femoral nail antirotation(PFNA).Methods From March2010 to December, twenty-seven cases of reverse intertrochanteric fractures were analyzed retrospectively.According to the AO/OTA classification,there were 4 cases in 31-A3.1,8 cases in 31-A3.2,15 cases in 31-A3.3.There were 15 males and12 female,aged from 41-95 years(mean,68 years).The left hip was involved in 14 patients and the right in 13 patients.The mechanism of injury was injury by falling in2 cases,traffic injuries in 2 cases,fall damage in 23 cases.Longitudinal traction on the traction table,mini-incision or closed was applied to aid reduction during the operation.All cases were treated with PFNA fixation.Clinical and radiographic outcomes were recorded.The postoperative hip funotion was evaluated using Harris hip score.Results With the aid of C-arm,closed reduction was performed in 17 cases and mini-incision reduction was performed in 10 cases.The operation time,blood loss,the frequency of X-ray exposure was 70.0 ± 14.1 minutes,160.0 ± 12.6 ml and 25 ± 5 times,respectively.Twenty-seven cases were followed up for 8 to 36 months(mean,16.5 months),Bone union was observed in all cases with the average time of 5.1 months(range,4-9).At final follow-up,the mean Harris hip score was91.2 points(range,87-95).Conclusion PFNA is one optional treatment method for reverse intertrochanteric fractures,with easy to utilize,minimal trauma,less bleeding,solid fixation,short operation time,low complication,high healing rate and early weight-bearing.We recommend this method be considered for the stabilisation of reverse intertrochanteric fractures in daily clinical practice.更多还原