股骨粗隆周围骨折PFNA治疗体会

Experience in the Treatment of Intertrochanteric Fractures with PFNA

摘要: 目的：探讨PFNA(螺旋刀片防旋股骨近端髓内钉系统)治疗股骨粗隆周围骨折的临床疗效。方法：2010年8月至2011年8月，对20例股骨粗隆周围骨折的患者行闭合复位PFNA固定，其中11例为股骨粗隆部骨折，骨折按Evans分型^[1]。9例股骨粗隆下骨折，骨折按Seinsheimer分类^[2]，所有患者获得8~48周随访。结果：骨折全部愈合，愈合时间为8~22周，平均14周，无感染、脂肪栓塞、深静脉血栓、骨折不愈合、髋内翻及旋转畸形等并发症发生。结论：PFNA治疗股骨粗隆周围骨折具有操作简单、创伤小、符合生物学固定原则、骨折固定牢固、并发症少及患者可早期离床负重等优点，尤其适合老年患者。

Abstract: Objective: To investigate the clinical curative effect of PFNA (Proximal Femoral Nail Antirotation) on inter- trochanteric fractures. Methods: From August 2010 to August 2011, 20 cases of intertrochanteric fractures patients underwent closed reduction fixation of PFNA. There are 11 cases of intertrochanteric fracture of the femur according to Evans classification^[1], 9 cases of subtrochanteric fractures according to Seinsheimer classification^[2]. All the patients were followed for 8 - 48 months. Result: All the fractures healed and the healing time was 8 - 22 weeks with an average of 14 weeks. No infection, fat embolism, deep vein thrombosis, nonunion, coxa vara or rotation deformity were experienced. Conclusion: PFNA for the treatment of intertrochanteric fracture has the advantages of being simple to operate, small trauma, consistent with the principles of biological fixation, firm fixation, less complications and early to get out of bed for patients, etc., which is particularly suitable for elderly patients.