摘要
目的探讨防旋型股骨近端髓内钉（PFNA）治疗老年骨质疏松性股骨粗隆间骨折的临床操作技巧及疗效。
方法选取采用PFNA治疗的老年骨质疏松性股骨粗隆间骨折患者38例，男10例，女28例；年龄（80.6±5.3）岁。致伤原因：行走跌伤26例，交通伤10例，动物撞跌伤2例。结果38例患者手术时间（37.0±7.0）min，术中失血量（80.0±12.0）ml，术后5例因年龄过高或基础疾病较多，转至ICU病房治疗1～2 d，平稳后转回普通病房。术后出现并发症7例，经相关科室联合积极处理后好转。所有患者伤口均为一期临床愈合，病情平稳出院。所有患者均得到随诊3～12个月，38例患者骨折全部愈合，愈合时间（10.0±3.5）周。随诊时，有4例患者自述患肢髋部和大粗隆区疼痛。
结论PFNA治疗老年骨质疏松性股骨粗隆间骨折，经临床操作技巧的改进，手术时间缩短，出血量明显减少，并发症减少，对于改善老年骨质疏松性股骨粗隆间骨折的预后，具有明显的疗效。
ObjectiveTo investigate the clinical skills and efficacy proximal femoral nail antirotation（PFNA） in treatment of osteoporosis intertrochanteric fratures of elderly patients.
MethodsThirty-eight cases of elderly osteoporotic intertrochanteric fractures treated by PFNA were selected. There were 10 males and 28 females with an average age of （80.6±5.3） years. Mechanism of injury： pedestrian injury in 26 cases, traffic accident in 10 cases and animal hit injury in 2 cases.
ResultsThe operative time was （37.0±7.0） min. The operative blood loss was （80.0±12.0） ml. Five cases were transferred to surgical intensive care for 1-2 d unit because of their excessive age or more basic disease, and returned to general ward when their condition were stable. Seven cases had complications after operation and recovered after symptomatic treatment. The wound healing was uniform in all patients. The mean duration of follow up was 3-12 months. The time of fracture healing was （10.0±3.5） weeks. The post-operative function was recovered to premorbid status in all the patients. Four patients complained of hip and great trochanteric pain.
ConclusionsThrough the improvement of clinical operation skills, PFNA has the advantages of easily manufacture, short operating time and minimal blood loss and fewer complications in treatment of elderly patients with osteoporsis intertrochanteric fracture. It has obvious curative effect on improving the prognosis of osteoporosis intertrochanteric fracture of elderly patients.
作者
陆根华
牟晓峰
Lu Genhua;Mu Xiaofeng(Department of Orthopedics, Changzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Changzhou 213003, China)
出处
《中国实用医刊》
2018年第6期80-83,共4页
Chinese Journal of Practical Medicine
关键词
股骨粗隆间骨折
骨质疏松
内固定术
防旋型股骨近端髓内钉
Intertrochanteric fracture
Osteoporosis
Internal fixation
Proximal femoral nail antirotation
