四川医学2018，Vol.39Issue(4)：449-452,4.DOI:10.16252/j.cnki.issn1004-0501-2018.04.023
股骨粗隆间骨折行股骨近端防旋髓内钉内固定术后失败的原因分析及手术经验总结
Failure Causes Analysis and Surgical Experience Summery of PFNA Internal Fixation in Femoral Intertrochanteric Fractures
万家兴 1王凯利 1宋雪 1马秋洁 1李萍2
作者信息
- 1. 中国中医科学院广安门医院南区,北京102618
- 2. 首都医科大学附属北京中医医院北京市中医研究所,北京100010
- 折叠
摘要
Abstract
Objective To analyze the clinical results of Proximal Femoral Nail Antirotation (PFN-A)in senile patients with femoral intertrochanteric fractures and to summarize the failure causes and treatment experience of PFN-A.Methods A total of 105 patients with femoral intertrochanteric fractures treated in our hospital with PFN-A surgery from January 2013 to March 2017 were enrolled in this study.The duration of operative,bleeding volume and Harris functional score after hip trauma were calculated.Then we fix the cause of failure and summarize the surgical experience.Results The duration of operation was 50 ～ 135min,the average of which was (87.27 ± 40.08)min.The intraoperative blood loss was 50 ～200mL,with an average of(107.69 ± 43.17) mL.The postoperative Harris score was excellent in 59 patients,good in 28 patients and moderate in 15 patients,while 3 cases got poor scores.Excellent and good rate was 82.86％.2 cases failed in internal fixation,one of which had primary nail fracture and the screw blade of the other screwed out of femoral head.Conclusion The main factors of PFN-A internal fixation failure were the poor fracture reduction and operative factors,followed by premature weight-bearing,weight factorsand severe osteoporosis.However,the PFN-A internal fixation is the first choice for senile patients with femoral intertrochanteric fractures.关键词
股骨粗隆间骨折/股骨近端防旋髓内钉/内固定失败Key words
femoral intertrochanteric fractures/proximal femoral anti-rotation intramedullary nail/internal fixation failure分类
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万家兴,王凯利,宋雪,马秋洁,李萍..股骨粗隆间骨折行股骨近端防旋髓内钉内固定术后失败的原因分析及手术经验总结[J].四川医学,2018,39(4):449-452,4.
