股骨近端防旋髓内钉治疗≥90岁股骨转子间骨折患者的疗效

目的评估股骨近端防旋髓内钉(PFNA)治疗≥90岁股骨转子间骨折患者的疗效。方法将94例采用PFNA治疗的股骨转子间骨折患者根据年龄分为A组(60~74岁)、B组(75~89岁)和C组(≥90岁),比较3组患者术前住院日、手术时间、术后输血量、术后输血率、术后半年髋关节Harris评分优良率和术后半年病死率。结果术前住院日、手术时间、术后输血量及术后半年髋关节Harris评分优良率3组患者比较差异均无统计学意义(P>0.05)。术后输血率C组明显高于A组和B组(P<0.001)。术后半年病死率C组高于A组和B组(P<0.01)。结论PFNA治疗≥90岁股骨转子间骨折患者效果良好,但术后半年病死率较高,且术后输血率高,需特别关注血红蛋白变化。

The effect of proximal femoral nail antirotation in treatment of intertrochanteric fractures in patients 90 years old and above

Objective To evaluate the efficacy of proximal femoral nail antirotation(PFNA)in the treatment of patients 90 years old and above with intertrochanteric fractures.Methods The 94 patients with intertrochanteric fractures were divided into group A(60~74 years old),group B(75~89 years old)and group C(90 years old and above).Preoperative hospitalization days,operation time,postoperative blood transfusion volume,postoperative blood transfusion rate,the excellent-good rate of Harris score and the mortality rate at 6 months after surgery were compared among three groups.Results The differences among the 3 groups in preoperative hospitalization days,operative time,volume of postoperative transfusion blood and excellent-good rate of Harris hip score were not statistically significant(P>0.05).The postoperative blood transfusion rate was significantly higher in group C than in group A and group B(P<0.001).Patients in group C had a high mortality rate within 6 months after the surgery,compared with group A and group B(P<0.01).Conclusions PFNA is effective in the treatment of intertrochanteric fractures in patients 90 years old and above,while the mortality rate at 6 months after surgery and postoperative transfusion rate is high in these patients.Special attention should be paid to postoperative hemoglobin changes.