闭合复位股骨近端防旋髓内钉治疗老年股骨转子间骨折的疗效-论文.pdf

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1、临床骨科杂志JournalofClinicalOrthopaedics2014Jun；17(3)·327·doi：10．3969／j．issn．1008-0287．2014．03．034·临床论著·闭合复位股骨近端防旋髓内钉治疗老年股骨转子问骨折的疗效王晶，叶泽兵，周晓忠，王帅鹗，李超，徐汪洋，李贵涛摘要：目的探讨采用闭合复位股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折的临床疗效。方法对79例老年股骨转子间骨折患者采用闭合复位PFNA内固定，对患者的手术时间、术中出血量、输血量、术后引流量、骨折愈合时间、手术相关并发症等进行分析。按Harris评分标准对髋关节

2、评分。结果手术时间39—88(51±14)min；术中出血量50～240(884-25)ml，其中31例术后输注浓缩红细胞1～4U；术后引流量4O～460(180±55)ml。1例术后27d死亡，78例获得随访，时间12—25个月。患者骨折全部愈合，愈合时间l3～22，4(16．54-3．2)周。出现褥疮1例，深静脉血栓1例，髋内翻畸形2例，发生头钉刺入髋臼1例，术后1年髋关节功能Harris评分：优69例，良6例，可3例，优良率为96．15％。结论闭合复位PFNA内固定治疗老年股骨转子间骨折创伤较小，操作简便，固定牢靠，安全有效。关键词：股骨骨折；骨折固定术，髓内；

3、股骨近端防旋髓内钉；闭合复位中图分类号：R683．42；R687．33；R687．1文献标识码：A文章编号：1008—0287(2014)03—0327—03Efectofclosereductionandproximalfemoralnailanti．rotationtotreatintertrochantericfracturesinelderlypatients^如，YEZe—bing，ZHOUXiao-zhong，WANGShuai-e，LIChao，Wang一，LIGui—tao(DeptofOrthopaedics，eSecondPeoplesHospit

4、alofGuang-如，Province，Guangzhou，Guangdong510317，China)Abstract：ObjectiveToexploretheclinicalefectofclosereductionandproximalfemoralnailanti—rotationfPF—NA)inthetreatmentoffemoralintertrochantericfractures．Methods79patientswithfemoralintertrochantericfrac-turesweretreatedbyclosedreduction

5、andPFNA．Operativetime，intraoperativebloodloss，volumeofbloodtransfu—sion，postoperativedrainage，clinicalhealingtimeandoperativerelatedcomplicationswereanalyzed．ThecriteriaofHarrisScoreonhipfunctionwasevaluated．ResultsOperativetimeranged39—88minwithanaveragetimeof51±14min．andtheintraoperat

6、ivebloodlossranged50—240mlwithanaveragevolumeof88±25m1．31patientsweretreatedwithbloodtransfusionofredbloodcellsinarangeof1～4U．Thevolumeofpostoperativedrainageranged40—460mlwithanaveragevolumeof180±55m1．Onepatientdiedat27dpostoperationand78patientswerefollowedupf0r12—25months．Allfracture

7、swerehealeduneventfullyafter13～22．4weekswithanaveragetimeof16．5±3．2weeks．Onepatientsufferedwithbedsoreandanotheronewithpostoperativedeepveinthrombo—sis．Hipvanlsdeformityin2cases，1casehappenedwithnailpiercedacetabulum．After1year，accordingtothecri—teriaofHarris，theresultswereexce