国产股骨近端髓内钉治疗老年股骨转子周围骨折

目的:探讨国产股骨近端髓内钉(proximalfemoralnail,PFN),在老年股骨转子周围骨折治疗中的应用、疗效及并发症。方法:总结自2002年3月-2004年5月使用国产PFN治疗56例股骨转子周围骨折(男25例,女31例;年龄62~84岁,平均70.2岁)。手术使用骨科牵引床,在C形臂X线机下行闭合复位、锁定技术。随访观察骨折愈合情况、颈干角变化,以关节功能、疼痛情况、是否畸形等制订随访标准。结果:56例中随访49例,平均随访时间6.5个月。全部病例骨折均愈合,1例术后感染,2例出现颈螺钉切割股骨头(其中1例出现明显的外旋短缩畸形)。关节功能恢复良好,优37例,良9例,可2例,差1例,优良率为93.8%。结论:国产PFN内固定具有损伤小、固定牢固、生物力学优点突出等特点,是治疗老年股骨转子周围骨折的有效方法之一。

Treatment of intertrochanteric fracture with proximal femoral nail(PFN) in senile patients

Objective:To study therapeutic effects and complications of the fixation by using made-in-China proximal femoral nail(PFN) fixation,in the treatment of intertrochanteric fracture in senile patients.Methods:From March 2002 to May 2004,56 patients with intertrochanteric fractures were treated with PFN fixation.Among the patients,25 patients were male and 31 patients were female,ranging in age from 62 to 84 years(mean 70.2 years). The traction bed was used in the operation,and close reduction and fixation was performed with assistance of C-arm X-ray machine.The evaluation criteria was decided based on fracture healing,changes of collodiaphyseal angle,joint function,postoperative pain and deformation.Results:Among 56 patients,49 were followed up for a mean period of 6.5 months.All of the fractures healed well.One patient had postoperative infection,and 2 patients had implant cut-outs(one of them had obvious extorsion and shortening deformity).According to evaluation criteria,37 patients obtained excellent results,9 good,2 fair and 1 bad.The excellent and good rate was 93.8%.Conclusion:PEN posses follow advantages:minimal wound,stable fixation,good biomechanics characteristics,and it is an effective method to treat intertrochanteric fracture in senile patients.