PFNA―Ⅱ治疗老年股骨转子间不稳定骨折.doc

PFNA―Ⅱ治疗老年股骨转子间不稳定骨折 　　【摘要】 目的：探讨应用亚洲型股骨近端防旋髓内钉（PFNA-Ⅱ）治疗老年股骨转子间不稳定骨折疗效果。方法：选取笔者所在医院2013年 1月-2015年12月收治的109例老年股骨转子间不稳定骨折患者，获得随访97例，男36例，女61例。骨密度-1.5～-4.5，；改良Evans分型，Ⅱ型27例，Ⅲ型38例，Ⅳ型24例，Ⅴ型8例。选用PFNA-Ⅱ固定。结果：平均手术时间（45±15）min，术中平均出血（110±50）ml，随访时间6～30个月，全部骨性愈合，愈合时间4～8个月。术后半年髋关节功能根据Harris评分评定为（95.7±3.7）分；根据髋关节相关评定标准评定，优74例，良15例，中5例，差3例，优良率91.7%。术后钉头骨质切割1例，轻度髋内翻畸形愈合2例，无其他并发症出现。结论：PFNA-Ⅱ适用于不稳定型亚洲老年股骨转子间骨质疏松性骨折，创伤小，疗效满意 【关键词】 PFNA-Ⅱ； 老年股骨转子间骨折； 疗效 doi：10.14033/j.cnki.cfmr.2016.35.073 文献标识码 B 文章编号 1674-6805（2016）35-0136-02 【Abstract】 Objective：To investigate the efficacy of the treatment of unstable intertrochanteric fractures in elderly patients with the treatment of proximal femoral proximal femoral nail antirotation Ⅱ（PFNA-Ⅱ）.Method：In our hospital，from January 2013 to December 2015，109 elderly patients with unstable intertrochanteric fractures were treated.97 cases were followed up，36 cases were male and 61 cases were female.Bone density -1.5 to -4.5；modified Evans classification，type Ⅱ was 27 cases，type Ⅲ was 38 cases，type Ⅳ was 24 cases，type Ⅴ was 8 cases.Asian proximal femoral nail antirotation Ⅱ（PFNA-Ⅱ） fixation was chosen.Result：The average operation time was （45±15）min，the average bleeding was （110±50）ml，the follow-up time was 6-30 months，all healed，and the healing time was 4-8 months.6 months after operation，，the evaluated score of the hip function was （95.7±3.7） according to the Harris score；according to hip joint evaluation criteria，excellent in 74 cases，good in 15 cases，medium in 5 cases，poor in 3 cases，excellent and good rate was 91.7%.There were 1 case of nail head bone cutting，2 cases of mild hip deformity，and no other complications.Conclusion：PFNA-Ⅱ is suitable for the unstable intertrochanteric osteoporotic fracture in Asian，with little trauma and satisfactory curative effect. 【Key words】 PFNA-Ⅱ； Elderly patients with intertrochanteric fractures； Curative effect First-authors address：Peoples Hospital of Xuyi County，Xuyi 211700，China 股骨?D子间