论文下载：防旋股骨近端髓内钉治疗股骨转子间骨折(论著)

防旋股骨近端髓内钉治疗股骨转子间骨折(1)

http://www.100md.com 2011年9月25日董国良黄金星黄晓蓉吴逢斌文波余洋

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     【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64 min(55~85 min)。平均失血量260 ml(150~450 ml)。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8 d(6~23 d)。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

    Treatment of intertrochanteric fractures fractures with the proximal femoral nail antirotationDONG Guoliang, HUANG Jinxing, HUANG Xiaorong, et al Department of Orthopedics, Traditional medicine Hospital of Xin Du City, XinDu Sichuan, 650500,China

    【Abstract】Objectiveto explore the clinical outcome of intertrochanteric fractures with the proximal femoral nail antirotation (PFNA)MethodsEighteen patients for intertochanteric fractures of the femur were treated with the proximal femoral nail antirotation from January 2009 to January 2011 There were 11 males and 7 females with an average age of 665 years(ranged from 23 to 82 years)Mechanism of injury：pedestrian injury in 13 cases，traffic accident in 3 cases and fall injury in 2 casesAO classification:A1 type in 3 cases,A2 type in 12 cases,A3 type in 3 cases, The fractures were reducted with closed reduction technique and fixed with the proximal femoral nail antirotationResults The mean operative time was 64 min (5585 min)The mean operative blood loss was 260 ml (150450 ml)Reaming in 6 cases andunreaming in 12 cases during operative procedure The median time to partical weightbearing was 8 d(623 d)The mean duration of follow up was 95 months (718 months)The wound healing was smoothly in 18 patientsThe average time of fracture heaking was55 months (48 months)The postoperative function was recovered to premorbid status in all patients One patient suffered varus deformity in 140due to the lateral entrying pointof the main nailConclusionThe proximal femoral nail antirotation can fixed intertrochanteric fractures safely with a minamally invasive,shorter operative time,less bleeding, antirotation capability, can be an early postoperative functional exercise,less complications,is the treatment of intertrochanteric fractures as a Better way ......

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