有限切开复位加长PFNA 内固定治疗复杂股骨粗隆下骨折疗效观察

王鹏斌，王立松，贾戊，苏秀君

（商洛市中心医院，陕西 商洛，726000）

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摘要：

目的 探讨有限切开复位加长PFNA 内固定在复杂股骨粗隆下骨折治疗中的效果。方法 将我院收治的SeinsheimerⅢ、 Ⅳ型股骨粗隆下骨折的16 例患者作为研究对象，均行股骨粗隆下骨折有限切开加长PFNA内固定定术，分析临床效果。 结果 患者平均手术时间（92.16±2.38）min；平均术中出血量（380.29±84.25）mL；且无患者出现切口感染等并发症。患者均获得12～48 个月的随访，骨折均愈合，且无患者出现内固定断裂或者术后再次骨折。髋关节功能Harris 评分优良率为93.75%。结论 PFNA 在股骨粗隆下骨折治疗中的生物力学优势较为显著，使用加长型PFNA 结合骨折局部有限切开辅助复位，能够有效 缩短手术时间，减少术中出血量，具有较好的临床推广价值。

关键词：股骨粗隆下骨折；加长型PFNA；有限切开复位

中图分类号：R687.3文献标志码：A文章编号：2096-1413(2017)36-0068-02

Therapy observation of limited incision reduction and internal fixation with long proximal femoral nail antirotation in the treatment of
complicated femoral subtrochanteric fracture
WANG Peng-bin, WANG Li-song, JIA Wu, SU Xiu-jun


(Shangluo Central Hospital, Shangluo 726000, China)

ABSTRACT: Objective To investigate the therapy of limited incision reduction and internal fixation with long proximal femoral nail antirotation (PFNA) in the treatment of complicated femoral subtrochanteric fracture. Methods A total of 16 cases of femoral trochanteric fractures patients underwent Seinsheimer Ⅲ and Ⅳ were enrolled and treated with limited incision reduction and internal fixation with long PFNA. The clinical effect was analyzed. Results The average operative time was (92.16±2.38) min, the average intraoperative blood loss was (380.29±84.25) mL and there was no patients with complications such as incision infection. All patients were followed up for 12 to 48 months. All patients had fractures healed, and no patients had internal fixation rupture or postoperative fracture again. Hip function Harris score had a excellent rate of 93.75%. Conclusion The biomechanical advantages of PFNA in the treatment of femoral subtrochanteric fracture are more significant. The use of extended PFNA combined with local limited incision assisted reduction can effectively shorten the operation time and reduce the intraoperative blood loss, which has a good clinical value.
KEYWORDS: femoral subtrochanteric fracture; long proximal femoral nail antirotation; limited incision reduction

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