加长防旋股骨近端髓内钉内固定治疗涉及粗隆下股骨多段骨折21例分析
Treatment with proximal femoral nail anti-rotation for multiple femoral fracture of proximal femur:an analysis of 21 cases
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摘要: 目的: 观察加长防旋股骨近端髓内钉(PFNA)内固定治疗涉及粗隆下股骨多段骨折的临床疗效。方法: 对21例涉及粗隆下股骨多段骨折患者采用加长PFNA治疗,手术均在骨科下肢牵引床上进行,在C型臂X线机辅助下骨折采用闭合或小切口切开复位加长PFNA内固定术。结果: 术后随访6~24个月,平均愈合时间4.8个月,其中2例延迟愈合,拔除远端交锁钉后6个月均愈合。参照全国股骨骨折疗效评定标准,优12例,良7例,差2例;优良率为90.5%。1例出现主钉略弯曲,但患者最终未受影响。结论: 加长PFNA操作简单,创伤小,出血少,防旋转,内固定牢靠,是一种治疗涉及粗隆下股骨多段骨折的理想内固定方法。Abstract: Objective: To observe the curative effect of proximal femoral nail-A anti-rotation (PFNA) in treating multisegmental femoral fracture of proximal femur by a new interlocking nail. Methods: Twenty-one cases with multisegmental of femur fractures of proximal femur had been treated with PFNA. The surgery was operated on orthopedic lower limb automatic traction bed,PENA was fulfilled under C-arm fluoroscopy monitoring. Results: The 21 cases were followed up for 6 to 24 months. All cases were well union. The average healing time was 4.8 months,except two patients' recovery was delayed. However,all of them had healed 6 months after PFNA was removed,and the function of hip and knee were well recovered. According to the recovery evaluation criteria of national femoral fracture,12 cases were excellent,7 were good,and 2 were poor. The acceptance rate was 90.5%. The major nail in one case was slightly curved,but the function was not affected. Conclusions: PFNA is a reliable fixation method for multisegmental fracture of femur from subtrochanteric to femoral condyle with less trauma and blood loss.