亚洲型股骨近端抗旋髓内钉微创治疗老年不稳定股骨转子间骨折.docVIP

亚洲型股骨近端抗旋髓内钉微创治疗老年不稳定股骨转子间骨折高均宏 朱海涛 冯健 王文跃 胡祖愉 王俭 胡江 刘洪新 （浙江省海盐县人民医院骨科，海盐 314300）【摘要】? 目的 亚洲型股骨近端抗旋髓内钉(proximal femoral nail anti-rotation Ⅱ，PFNA-Ⅱ)治疗老年不稳定股骨转子间骨折临床效果。方法 2009年2月到2010年10月采用PFNA-Ⅱ治疗46例老年股骨转子间骨折患者，男20例, 女26例;年龄63～92 岁,平均72岁。按Tronzo-Evans分型,标准：Ⅲ型18例，Ⅳ型22例，逆转子间骨折6例。受伤至手术时间2～13天,平均6天。结果 按Harris髋关节功能评分: 优26例,良10例,中4例,差2例,优良率85.71%。本组未出现髋内翻，内固定物失效及切割现象。结论 PFNA-Ⅱ内固定具有操作简单、手术创伤小、固定可靠、符合微创理论特点，是目前治疗老年性不稳定股骨转子间骨折患者的理想内固定材料。【关键词】股骨近端抗旋髓内钉；微创；股骨转子间骨折；内固定Minimally invasive treatment of elderly unstable femoral intertrochanteric fracture with proximal femoral nail anti-rotation Ⅱ GAO Jun-hong,ZHU Hai-tao,FENG Jian,WENG Wen-yue,HU Zhu-yu,WANG Jian,HU Jiang,LIU Hongxin.Department of Orthopaedics,Haiyan Hospital,Haiyan 314300,Zhejiang,China.ABSTRACT Objective To explore the clinical effects in the treatment of elderly unstable femoral intertrochanteric fracture with Proximal Femoral Nail Anti-rotation Ⅱ(PFNA-Ⅱ). Methods 46 elderly patients with unstable femoral intertrochanteric fractures were treated by PFNA-Ⅱ from February 2009 to October 2010.included 20 males and 26 females with average age of 72years ranging from 63 to 92 years.Based upon Tronzo-Evans classification,type Ⅲ fractures were diagnosed in 18case, type Ⅳ in 22,and type of reverse femoral intertrochanteric fracture in 6. The time from injury to operation was ranged 2~13 days, (with an average 6 days).Results: According to Harris Hip score criterion，the results of 26 excellent cases, 10 were good and 4 were fairand 2 was poor.The excellent and good rate of the function of the hip joint was 85.71％.without occurence of varus deform ity,hardwareloosening or hardware cutting. Conclusion? It is ideal method to treat unstable femoral intertrochanteric fracture with PFNA-Ⅱ in elderly patients for the procedure is convenient, less surgical trauma，stable fixation and Minimally invasive .Key words? proximal femoral nail antirotation；Minimally invasive ;femoral intertrochanteric fracture；internal fixation股骨粗隆间骨折多