股骨近端抗旋髓内钉法治疗老年股骨转子下粉碎性骨折的效果分析

目的:探讨利用股骨近端抗旋髓内钉法治疗老年股骨转子下粉碎性骨折的临床效果,为临床提供参考。方法:对我院2009年6月-2013年1月收治的38例老年股骨转子下粉碎性骨折患者行股骨近端抗旋髓内钉法进行手术治疗,分析手术方法、效果及患者的预后效果。结果:28例行闭合复位,7例行骨折端切开复位,患者术后7-14d可下地活动,3 m内扶拐部分负重行走,31例(88.6%)获得随访,随访时间9-24个月,骨折愈合时间为3-6个月,平均3.7个月;Harris髋功能评分标准:优18例,良10例,中3例,优良率90.32%(28/31)。结论:PFNA是一种治疗老年股骨转子下粉碎性骨折的有效装置,能够减少骨折不愈合、髋内翻畸形愈合及内固定断裂、切割股骨头等并发症,在治疗老年股骨转子下粉碎性骨折时可达到较高的骨愈合率、较快的功能恢复。

Clinical Effect of Proximal Femoral Nail Antirotation on the Treatment ofFemoral Subtrochanteric Comminuted with Fracture in Elderly Patients

Objective:To explore the clinical effect of proximal femoral nail antirotation (PFNA) in treating femoral subtrochantericcomminuted fracture in elderly and provide references for clinical nursing work.Methods:PFNA surgery was conducted on35 cases of femoral subtrochanteric comminuted fracture elder patients admitted in our hospital fromJune 2009 to Jan 2009. The surgicalmethods, effect and prognosis were analyzed.Results:28 cases received closed reduction and 7 cases received open reduction at fractureend. All cases went to ground activity 7-14d after the surgery and some could walk with load and a stick in 3m. 31 cases (88.6%) had follow-up and the follow-up time was 9-24 m. The facture healing time was 3-6mand 3.7m for average. The healing condition was assessedusing Harris Hip Score and the results were: 18 for Excellent, 10 for Good and 3 for Medium. The excellence and good rate was 90.32%(28/31).Conclusion:PFNA is an effective equipment in treating femoral subtrochanteric comminuted fracture in elderly. It can reducecomplications such as nonunion, hip varus malunion, facture of internal fixation and cutting femoral bone, and achieve higher rate ofbone healing and quicker function recovery.