应用PFNA治疗股骨转子周围骨折体会
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摘要
目的探讨应用股骨近端防旋髓内钉(PFNA)治疗股骨转子周围骨折的疗效。方法对该院2016年8月—2018年1月应用PFNA治疗66例股骨转子周围骨折进行分析,观察手术出血量、手术时间、螺旋刀片退出现象,采用Harris评分评估治疗效果。结果术后随访螺旋刀片退出1例,骨折复位及愈合不良1例,64例获得良好的骨性愈合。结论股骨近端防旋髓内钉(PFNA)符合股骨转子周围骨折生物力学要求,治疗股骨转子周围骨折效果满意。
Objective To study the curative effect of PFNA in treatment of peritrochanteric fracture of femur. Methods 66 cases of patients with peritrochanteric fracture of femur admitted and treated in our department from August 2016 to January 2018 were analyzed, and the intraoperative bleeding amount, operation time, spiral blade withdrawal phenomenon were observed, and the treatment effect was evaluated by the Harris evaluation. Results The follow-up after surgery showed that there was 1 spiral blade withdrawal case, 1 case with fracture reduction and adverse healing, and 64 cases could obtain a good bone healing. Conclusion The PFNA meets the requirement of biomechanics of the peritrochanteric fracture of the femur, and the treatment effect of peritrochanteric fracture of femur is satisfactory.
Objective To study the curative effect of PFNA in treatment of peritrochanteric fracture of femur. Methods 66 cases of patients with peritrochanteric fracture of femur admitted and treated in our department from August 2016 to January 2018 were analyzed, and the intraoperative bleeding amount, operation time, spiral blade withdrawal phenomenon were observed, and the treatment effect was evaluated by the Harris evaluation. Results The follow-up after surgery showed that there was 1 spiral blade withdrawal case, 1 case with fracture reduction and adverse healing, and 64 cases could obtain a good bone healing. Conclusion The PFNA meets the requirement of biomechanics of the peritrochanteric fracture of the femur, and the treatment effect of peritrochanteric fracture of femur is satisfactory.
引文
[1]谢逸波,曾波,李培浩,等.股骨近端防旋髓内钉和解剖锁定钢板治疗老年股骨转子间骨折的效果比较[J].中国矫形外科杂志,2017,25(10):950-953.
[2]沈政,余润泽,喻德富,等.股骨近端锁定钢板与防旋髓内钉治疗稳定型股骨转子间骨折的疗效分析[J].创伤外科杂志,2018,20(1):23-26.
[3]王小芃.PFNA与Inter Tan内固定系统治疗股骨转子间骨折疗效比较研究[J].中国医药科学,2017,7(1):137-139.
[4]张亚,李健华,刁天月,等.股骨近端防旋髓内钉治疗老年股骨转子间骨折[J].临床骨科杂志,2015,18(5):604.
[5]Harris WH.Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty.An end-result studyusing a new method of result evaluation[J].J Bone Joint Surg(Am),1969,51(4):737-755.
[6]陈星华.不同内固定方式治疗老年股骨转子间骨折的疗效对比[J].浙江创伤外科,2018,23(01):68-69.
[7]Cho HM,Lee K.Clinical and Functional Outcomes of Treatment for Type A1 Intertrochanteric Femoral Fracture in Elderly Patients:Comparison of Dynamic Hip Screw and Proximal Femoral Nail Antirotation[J].Hip Pelvis,2016,28(4):232-242.
[8]Brunner A,Büttler M,Lehmann U,et al.What is the optimal salvage procedure for cut-out after surgical fixation of trochanteric fractures with the PFNA or TFN:A multicentre study[J].Injury-international Journal of the Care of the Injured,2015,47(2):432-438.
[9]Chinzei N,Hiranaka T,Niikura T,et al.Comparison of the Sliding and Femoral Head Rotation among Three Different Femoral Head Fixation Devices for Trochanteric Fractures[J].Clinics in Orthopedic Surgery,2015,7(3):291-297.
[10]王为,朱道平,严宏伟,等.3种内固定方法治疗高龄股骨转子间骨折疗效分析[J].临床骨科杂志,2015,18(1):73-76.
[11]郑江生.PFNA微创治疗老年性股骨转子间骨折的临床效果观察[J].数理医药学杂志,2018,31(1):43-44.
[2]沈政,余润泽,喻德富,等.股骨近端锁定钢板与防旋髓内钉治疗稳定型股骨转子间骨折的疗效分析[J].创伤外科杂志,2018,20(1):23-26.
[3]王小芃.PFNA与Inter Tan内固定系统治疗股骨转子间骨折疗效比较研究[J].中国医药科学,2017,7(1):137-139.
[4]张亚,李健华,刁天月,等.股骨近端防旋髓内钉治疗老年股骨转子间骨折[J].临床骨科杂志,2015,18(5):604.
[5]Harris WH.Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty.An end-result studyusing a new method of result evaluation[J].J Bone Joint Surg(Am),1969,51(4):737-755.
[6]陈星华.不同内固定方式治疗老年股骨转子间骨折的疗效对比[J].浙江创伤外科,2018,23(01):68-69.
[7]Cho HM,Lee K.Clinical and Functional Outcomes of Treatment for Type A1 Intertrochanteric Femoral Fracture in Elderly Patients:Comparison of Dynamic Hip Screw and Proximal Femoral Nail Antirotation[J].Hip Pelvis,2016,28(4):232-242.
[8]Brunner A,Büttler M,Lehmann U,et al.What is the optimal salvage procedure for cut-out after surgical fixation of trochanteric fractures with the PFNA or TFN:A multicentre study[J].Injury-international Journal of the Care of the Injured,2015,47(2):432-438.
[9]Chinzei N,Hiranaka T,Niikura T,et al.Comparison of the Sliding and Femoral Head Rotation among Three Different Femoral Head Fixation Devices for Trochanteric Fractures[J].Clinics in Orthopedic Surgery,2015,7(3):291-297.
[10]王为,朱道平,严宏伟,等.3种内固定方法治疗高龄股骨转子间骨折疗效分析[J].临床骨科杂志,2015,18(1):73-76.
[11]郑江生.PFNA微创治疗老年性股骨转子间骨折的临床效果观察[J].数理医药学杂志,2018,31(1):43-44.