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1、防旋股骨近端髓内钉治疗股骨转子间骨折【摘要】目的评价防旋股骨近端髓内钉治疗股骨转子间骨折的临床疗效。方法2009年1月至2011年1月，采用防旋股骨近端髓内钉治疗股骨转子间骨折18例，男11例，女7例：年龄23~82岁，平均66�5岁。受伤原因：步行跌伤13例，车祸伤3例，高处坠落伤2例。AO分型：A1型3例，A2型12例，A3型3例。骨折采用闭合复位，防旋股骨近端髓内钉内固定术。结果平均手术时间64min(55~85min)。平均失血量260ml(150~450ml)。术中6例须扩髓即可放入主钉，12例无须扩髓即可放入主钉。平均部分负重时间8d(6
2、~23d)。平均随访9�5个月(7~18个月)。切口均一期愈合，骨折平均5�5个月愈合(4~8个月)，术后功能均恢复到伤前水平，1例主钉入点偏外导致140内翻。结论防旋股骨近端髓内钉可以有效地固定股骨转子间骨折，手术时间短，出血少，抗旋转能力强，可早期功能锻炼，并发症少，是治疗股骨转子间不稳定性骨折的较好方法。【关键词】股骨转子间；骨折固定术；内;内固定器Treatmentofintertrochantericfracturesfractureswiththeproximalfemoralnailanti�rotationDONGGuo�liang,
3、HUANGJin�xing,HUANGXiao�rong,etal�DepartmentofOrthopedics,11TraditionalmedicineHospitalofXinDu�City,Xin�DuSichuan,650500,China【Abstract】Objectivetoexploretheclinicaloutcomeofintertrochantericfractureswiththeproximalfemoralnailanti�rotation(PFNA)�MethodsEighteenpatientsforintert
4、ochantericfracturesofthefemurweretreatedwiththeproximalfemoralnailanti�rotationfromJanuary2009toJanuary2011Therewere11malesand7femaleswithanaverageageof66�5years(rangedfrom23to82years)�Mechanismofinjury：pedestrianinjuryin13cases，trafficaccidentin3casesandfallinjuryin2cases�AOcl
5、assification:A1typein3cases,A2typein12cases,A3typein3cases,Thefractureswerereductedwithclosedreductiontechniqueandfixedwiththeproximalfemoralnailanti�rotation�ResultsThemeanoperativetimewas64min(55�85min)�Themeanoperativebloodlosswas260ml(150�450ml)�Reamingin6casesandunreamingi
6、n12casesduringoperativeprocedure�Themediantimetopartical11weight�bearingwas8d(6�23d)�Themeandurationoffollowupwas9�5months(7�18months)�Thewoundhealingwassmoothlyin18patients�Theaveragetimeoffractureheakingwas5�5months(4�8months)�Thepostoperativefunctionwasrecoveredtopremorbidst
7、atusinallpatients�Onepatientsufferedvarusdeformityin140duetothelateralentryingpointofthemainnail�ConclusionTheproximalfemoralnailanti�rotationcanfixedintertrochantericfracturessafely�withamina�mallyinvasive,shorteroperativetime,lessbleeding,anti�rotationcapability,canbeanearlyp
8、ostoperativefunctionalexercise,lesscomplications,isthe
