【摘要】：目的通過隨訪觀察分析股骨近端防旋髓內(nèi)釘(PFNA)治療A2型股骨粗隆間骨折的臨床療效。方法選取2015年10月-2016年10月,就診于我院創(chuàng)傷骨科選用PFNA治療A2型股骨粗隆間骨折患者共80例進(jìn)行回顧性研究。所選患者根據(jù)AO分型均為A2型骨折,均為閉合性單側(cè)粗隆間骨折,其中男33例,女47例,年齡65~93歲之間,平均年齡74.51±9.20歲。記錄每例患者的手術(shù)時(shí)間、切口長(zhǎng)度、術(shù)中出血量、術(shù)中X線透視次數(shù)、術(shù)后患者下地時(shí)間、骨折愈合時(shí)間、術(shù)后并發(fā)癥、術(shù)后Harris評(píng)分。結(jié)果80例隨訪患者中,4例失訪,76例患者獲完全隨訪,失訪率為5%,隨訪時(shí)間6-18個(gè)月。平均手術(shù)時(shí)間63.75±7.75min,平均切口長(zhǎng)度6.46±0.92cm,平均術(shù)中出血量108.62±14.64ml,術(shù)中平均X線透視次數(shù)13.45±1.74次,平均住院時(shí)間10.37±1.83天,術(shù)后患者平均下地負(fù)重時(shí)間15.04±3.27天,骨折平均臨床愈合時(shí)間74.63±12.04天,根據(jù)Harris髖關(guān)節(jié)評(píng)分標(biāo)準(zhǔn):優(yōu)19例,良34例,可21例,差2例,優(yōu)良率為69.74%。結(jié)論微創(chuàng)PFNA技術(shù)是一種治療A2型股骨粗隆間骨折的可靠方法,其術(shù)程短、手術(shù)創(chuàng)傷小、固定牢靠,允許早期功能鍛煉,能減少并發(fā)癥發(fā)生,但術(shù)中X線暴露次數(shù)多。股骨粗隆間骨折在我區(qū)的發(fā)病率逐年增高,本次對(duì)我院使用PFNA治療股骨粗隆間骨折隨訪研究,充分肯定了其臨床療效,是一種值得推廣的治療股骨粗隆間骨折的手術(shù)方法,對(duì)我區(qū)治療股骨粗隆間骨折提供了一定的理論依據(jù)。
[Abstract]:Objective to observe and analyze the clinical effect of (PFNA) on type A 2 intertrochanteric fracture of femur. Methods from October 2015 to October 2016, 80 patients with type A2 intertrochanteric fracture were treated with PFNA in our department of trauma and orthopedics. According to AO classification, all the patients were type A2 fractures, all of them were closed unilateral intertrochanteric fractures, including 33 males and 47 females, aged between 6593 and 9.20 years, with an average age of 74.51 鹵9.20 years. Time of operation, length of incision, amount of intraoperative bleeding, times of X-ray fluoroscopy, time of landing, time of fracture healing, postoperative complications and postoperative Harris score were recorded. Results of the 80 cases, 4 cases lost the visit and 76 cases were followed up completely. The lost visit rate was 5%. The follow-up time was 6 to 18 months. The average operative time was 63.75 鹵7.75 min, the average incision length was 6.46 鹵0.92 cm, the average intraoperative bleeding was 108.62 鹵14.64 ml, the average number of X-ray fluoroscopy was 13.45 鹵1.74, and the average hospital stay was 10.37 鹵1.83 days. The average weight loading time was 15.04 鹵3.27 days, and the average clinical healing time was 74.63 鹵12.04 days. According to Harris hip scoring criteria, 19 cases were excellent, 34 cases were good, 21 cases were fair and 2 cases were poor. The excellent and good rate was 69.74%. Conclusion minimally invasive PFNA technique is a reliable method for the treatment of A2 type intertrochanteric fracture of femur. The procedure is short, the operation trauma is small, the fixation is firm, the early functional exercise is allowed, and the complication can be reduced, but the times of X-ray exposure during operation are more. The incidence of intertrochanteric fracture of femur is increasing year by year. This follow-up study on the treatment of intertrochanteric fracture with PFNA in our hospital has fully confirmed its clinical curative effect and is a kind of operative method worth popularizing in treating intertrochanteric fracture of femur. It provides a theoretical basis for the treatment of intertrochanteric fracture of femur.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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