闭合复位PFN内固定治疗股骨粗隆间骨折

摘要：目的] 探讨PFN治疗股骨近端骨折的应用及疗效，讨论其生物力学特点及手术细节。方法] 2006年4月～2009年8月我科应用闭合复位PFN内固定治疗21例股骨粗隆间骨折，其中，男13例，女8例；年龄32～84岁，平均62.7岁。据Evans-Jensen股骨粗隆骨折分型标准，I型2例，Ⅱ型6例，ⅢA型7例，ⅢB型5例，Ⅳ型1例。术后复查x线片判断骨折愈合的情况，随访各型骨折术后并发症的发生情况，根据Harris髋关节评分评定关节功能优良率，并对手术时间、术中失血量、术后骨折愈合时间及髋关节功能情况进行临床分析及功能评分。结果] 住院期间无死亡病例， 21例均获得随访，时间9-15个月，平均13个月，骨折全部愈合，参照Harris髋关节功能评分标准评价术后功能，优18例，良2例，中1例，优良率95.2％ 。结论] PFN治疗股骨粗隆间骨折具有优良的生物力学效能，手术创伤小，病人可早期功能活动，并发症少等优点，是治疗老年人股骨粗隆间骨折的一种理想的内固定方法。

Closed reduction and proximal femoral nail internal fixation in the treatment of the intertrochanteric fracture

Objective To investigate the application and curative effect on paoximal femoral nail (PFN) in the treatment of intertrochanteric fracture of femur. Methods From April 2004 to August 2009, 48 cases with intertrochanteric fracture of femur received treatment of closed reduction and OFN internal fixation were analyzed retrospectively. According to Evans-Jensen typing criterion of intertrochanteric fracture of femur, the type Ⅰ,Ⅱ,ⅢA,ⅢB AND Ⅳ were in 2,6,7,5 and 3 cases respectigely. Roentgenograph was re-checked to judge the union good rates of articular function were evaluated. Results No death was found during hospitalization. Except for 2 cases died from cardiovascular systemic diseases, follow-up was got in 21 cases. The follow-up time ranged from 9-15 months(mean 13 months). The union was got in all cases. The postoperative hip joint function score: the excellent, good and poor were in 18,2 cases and 1 case respectively. The excellent and good rate were in 95%. Conclusion PFN possesses less trauma;reliable fixation, good anti-rotated action and less postoperative complications. It is an ideal method of internal fixation for the treatment of intertrochanteric fracture of femur.