摘要
[目的]探讨改良股骨近端髓内钉治疗股骨粗隆周围骨折的疗效，讨论其力学特点及手术中注意事项。[方法]作者自2002年4月-2005年3月应用闭合复位改良股骨近端髓内钉（PFN）内固定治疗股骨粗隆周围骨折81例，其中，男45例，女36例；年龄35-91岁，平均63．3岁。按Evans股骨粗隆骨折分型标准，I型5例，Ⅱ型10例，ⅢA型12例，ⅢB型21例，Ⅳ型28例，逆粗隆型5例。随访各型骨折术后并发症的发生情况、临床愈合时间及功能评分。[结果]有15例失去随访，住院期间无死亡病例，后期随访中有4例死于其他系统疾病。62例获得随访，时间12-47个月，平均28．6个月，骨折全部愈合，参照Harris髋关节功能评分标准评价术后功能，优56例，占90．3％，良2例，占3．2％，差4例，占6．5％。[结论]改良PFN治疗股骨粗隆周围骨折具有手术创伤小，固定牢固，病人可早期功能活动，并发症少等优点，是治疗股骨粗隆周围骨折的理想方法。
[ Objective] To investigate the clinical outcomes of treatment of intertrochanteric and subtrochanteric fractures of the femur with the improved proximal femoral nail（PFN）. [ Method] Between April, 2002 to Mach 2005, a total of 81 cases of intertrochanteric and subtrocha nteric femoral fractures were treated with close reduction and the improved PFN. There are 45 males and 36 females, with an average age of 63.6 （35 to 91 ）. According to the Evans classification： there are 5 cases of type I , 10 cases of type Ⅱ, 12 cases of type Ⅲ A, 21 cases of type Ⅲ B, 28 cases oftypel V, 5 cases of type against femoral peritro- chanteric. [ Result] Sixty-two cases were followed up for 12 to 47 months, averaged 28.6 months. Fracture union was obtained in all the patients. Of 62 cases, one case had according to Harris criterion 56 cases were excellent, （ rate 90.3% ） and 2 cases good （3.2%） excellent and good rate of the function of the hip joint was 93.5%. [ Conclusion ] The improved PFN is a useful device in the treatment of perit rochanteric fractures of the femur. It is relatively easy with less surgical trauma, it and also has the advantages of anti-rotation, stress - dispersing, rigid fixation and allowing early functional exercises. The complications can be avoided with improved operative technique.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第20期1537-1539,共3页
Orthopedic Journal of China
关键词
股骨近端髓内钉(PFN)
股骨粗隆骨折
内固定
Proximal femoral nail （PFN）
Pperitrochanteric femoral fracture
internal fixation
