PFNA治疗老年骨质疏松性股骨粗隆间骨折

The Clinical Effects of Proximal Femoral Nail Anti-Rotation (PFNA) on the Treatment of the Senile Osteoporotic Femoral Intertrochanteric Fractures

摘要: 目的：探讨防旋型股骨近端髓内钉(Proximal Femoral Nail Anti-Rotation, PFNA)治疗老年骨质疏松性股骨粗隆间骨折的疗效。方法：自2010年11月~2013年11月应用PFNA治疗34例老年骨质疏松性股骨粗隆间骨折的患者。骨折按照AO分型，A1型10例A2型13例A3型11例。统计手术时间，术中出血量，术后进行骨质疏松的治疗及术后骨折愈合时间；随访6~11个月。结果：34例患者平均手术时间65分钟，术中出血量平均160 ml，所有病例随访6~11个月骨折均愈合，平均愈合时间7.5个月。无断钉、切割、髋内翻等现象。根据Harris评分：优25例，良7例，可2例，优良率：94.1%。结论：PFNA治疗老年骨质疏松性股骨粗隆间骨折，创伤小，固定牢固，操作方便，有利于患者骨折早期愈合和肢体功能恢复。

Abstract: Objective: To observe the therapeutic effect of senile osteoporotic femoral intertrochanteric fractures treated with proximal femoral nail anti-rotation (PFNA). Method: From 2010 to 2013, 34 cases (11 males, 23 females) of senile osteoporosis femoral intertrochanteric fractures were treated with PFNA, who aged from 62 to 87. According to the classification of AO, there were 10 cases of A1, 13 cases of A2, 11 cases of A3. Operative time, volume of blood loss and the condition of fracture union were observed with the follow-up of 6 - 11 months. Results: mean operating time was 65 minutes, mean intraoperative bleeding volume was 160 ml, cases were followed up from 6 months to 11 months, and mean healing time was 7.5 months. According to the Harris criterion for evaluation, the effects were excellent in 25 cases, good in 7 cases and fair in 2 cases, the excellent and good rate was 94.1%. Conclusion: The treatment of senile osteoporosis femoral intertrochanteric fracture with PFNA is less traumatic, fixed firmly and operated simply, in favor of fracture healing and function recover.