摘要
目的探讨特殊体位下非牵引床复位股骨近端防旋髓内钉（PFNA）固定治疗股骨转子间骨折的临床疗效。方法回顾性分析2016年5月至2017年5月期间采用PFNA固定治疗的34例股骨转子间骨折患者资料。男20例，女14例；年龄为36～89岁，平均69．9岁；左侧15例，右侧19例。骨折AO分型：31-A1型10例，31-A2型13例，31-A3型11例。合并其他部位骨折2例；合并内科系统疾病5例，其中3例患者合并2种以上疾病。术前发现下肢深静脉血栓形成2例。所有患者均在受伤后2～8d（平均3．7d）行手术治疗。术中均采用特殊体位下非牵引床复位。记录患者的手术时间、术中出血量、术后并发症发生情况及髋关节功能等。结果34例患者的麻醉时问为57—85min，平均67．5min；手术时间为28-65min，平均40．9min；术中出血量为80—150mL，平均110．6mL。34例患者术后获6—12个月（平均8．4个月）随访。本组患者骨折均获愈合，愈合时间为6～12个月（平均7．2个月）。随访期间未出现内固定物切割及松动等并发症。末次随访时根据髋关节Harris评分标准评定患髋功能：优9例，良21例，可4例，优良率为88．2％。结论特殊体位下非牵引床复位PFNA固定治疗股骨转子问骨折可减少麻醉时间．临床效果满煮。
Objective To study the treatment of femoral intertrochanteric fractures by reduction without a traction table in a special position and fixation with proximal femoral nail antirotation （PFNA）. Methods From May 2016 to May 2017, 34 patients with femoral intertrochanteric fracture were treated with PFNA. They were 20 men and 14 women, from 36 to 89 years of age （average, 69. 9 years）. The left side was affected in 15 cases and the right side in 19. By AO classification, there were 10 cases of type AO 31-A1, 13 ones of type 31-A2, and 11 ones of type 31-A3. Two cases were complicated with other fractures, and 5 with internal system disease, 3 of whom had more than 2 concomitant diseases. Preoperative deep venous thrombosis was found in 2 cases. Surgery was performed for them between 2 and 8 days after injury （average, 3.7 days）. Reduction was performed in a special position without a traction table. The duration of anesthesia, operation time, intraoperative hemorrhage, postoperative complications and hip function by Harris scores were recorded. Results For the 34 patients, the anesthesia time ranged from 57 to 85 min （average, 67.5 min）, the operation time ranged from 28 to 65 min （average, 40. 9 min）, and the intraoperative hemorrhage from 80 to 150 mL （average, 110.6 mL）. They received effective follow-up for 6 to 12 months （average, 8.4 months）. All the fractures healed after 6 to 12 months（average, 7.2 months） . No failure of internal fixation was observed during follow-ups. By the Harris scores at the final follow-up, the function of the affected hip was rated as excellent in 9 cases, as good in 21 and as fair in 4, giving an excellent to good rate of 88.2%. Conclusion In the treatment of femoral intertrochanteric fractures, reduction without a traction table in a special position and PFNA fixation may reduce anesthesia time, leading to satisfactory clinical outcomes.
作者
马金龙
吾路汗·马汉
罗雪峰
唐亚辉
王仲正
谢增如
Ma Jinlong, Wuluhan · Mahan, Luo Xuefeng, Tang Yahui, Wang Zhongzheng, Xie Zengru(Department of Trauma Orthopaedic Surgery, The First Affiliated Hospital to Xinjiang Medical University, Urumqi 830000, Chin)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2018年第3期258-262,共5页
Chinese Journal of Orthopaedic Trauma
基金
国家自然科学基金（81660368）
关键词
髋骨折
骨折固定术
髓内
骨钉
非牵引床
特殊体位
Hip fractures
Fracture fixation, intramedullary
Bone nails
Non-traction table
Special position
