熊飞龙++++++李江龙++++++刘继波++++++谢大伟++++++周鹏

[摘要] 目的 观察股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的临床效果。 方法 选取2010年3月～2012年12月本科收治的30例老年股骨粗隆间骨折患者为研究对象，均采用股骨近端防旋髓内钉治疗，采用Harris评分系统对其髋关节功能进行评价。 结果 27例获得12个月以上的随访，随访时间12～36个月，平均21个月，术后定期复查X线片，未见内固定松动、断裂、髋关节活动受限、股骨头塌陷、骨不连，髋关节内、外翻畸形，下肢短缩、螺旋刀片切割股骨头、感染等并发症。髋关节Harris评分：优19例，良6例，可2例，优良率为92.59%。 结论 股骨近端防旋髓内钉治疗老年股骨粗隆间骨折，符合微创治疗原则、手术操作简单、固定可靠、术后并发症少等，临床疗效满意。

[关键词] 股骨近端防旋髓内钉；老年；股骨粗隆间骨折

[中图分类号] R683.42[文献标识码] B[文章编号] 1674-4721（2014）06（a）-0186-03

Effect observation of percutaneous femoral proximal screw intramedullary nail treatment of the elderly femoral intertrochanteric fractures

XIONG Fei-long LI Jiang-long LIU Ji-bo XIE Da-wei ZHOU Peng

People′s Hospital of Xingyi City in Guizhou Province,Xingyi 562400,China

[Abstract] Objective To observe the clinical effect of percutaneous femoral proximal screw intramedullary nail treatment of the elderly femoral intertrochanteric fractures. Methods 30 patients with elderly femoral intertrochanteric fractures in our hospital from March 2010 to December 2012 were selected as the research object,they all given the percutaneous femoral proximal screw intramedullary nail treated,the Harris scoring system was used to evaluate its hip joint function. Results 27 cases followed-up for more than 12 months,followed up for 12 to 36 months,an average of 21 months,postoperative X-ray film,periodic review did not see limited internal fixation loosening and fracture,hip activities,in the collapse of the femoral head bone nonunion,hip,valgus,lower limb shortening,spiral blade cutting femoral head,complications such as infection.Harris hip score:excellent in 19 cases,good in 6 cases,approve in 2 cases,the excellent and good rate was 92.59%. Conclusion percutaneous femoral proximal screw intramedullary nail treatment of the elderly femoral intertrochanteric fractures,conform to the principle of minimally invasive treatment,simple operation,reliable fixation,less postoperative complications,clinical curative effect is satisfied.

[Key words] PFNA;Older;Femoral intertrochanteric fractures

股骨粗隆间骨折是老年人常见的骨折，有报道显示，其占髋部骨折的57.4%[1]，随着社会人口的老年化，近年来老年股骨粗隆间骨折明显增多[2]。其保守治疗时间长，而由此导致的并发症往往是致命的，故临床上对老年股骨粗隆间骨折多采用手术治疗，由于老年人骨质条件不好，要获得并维持稳定的固定比较困难[3-5]。股骨近端防旋髓内钉作为一种治疗股骨粗隆间骨折的新型内固定材料，由于其独特的优点而受广大临床医师的喜爱[6]。本科2010年3月～2012年12月对30例老年股骨粗隆间骨折采用闭合复位、股骨近端防旋髓内钉内固定治疗，取得了满意的临床效果。……