中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (35): 6535-6539.doi: 10.3969/j.issn.2095-4344.2012.35.015

• 骨科植入物 orthopedic implant • 上一篇    下一篇

股骨近端抗旋转髓内钉置入治疗老年不稳定型股骨转子间骨折

谢海明1,金正帅2,李 勇1,严雪飞1,俞 健1   

  1. 1江苏省人民医院盛泽分院骨外科,江苏省苏州市 215228;
    2江苏省人民医院骨外科,江苏省南京市 210000
  • 收稿日期:2012-01-23 修回日期:2012-02-26 出版日期:2012-08-26 发布日期:2012-08-26
  • 通讯作者: 金正帅,主任医师,江苏省人民医院骨科,江苏省南京市210000 jinzhengshuai@medmail.com.cn
  • 作者简介:谢海明,男,1968年生,江苏省吴江市人,汉族,1992年扬州大学医学院毕业,副主任医师,主要从事创伤以及关节术后随访以及临床技能研究。 oscar1629@126.com

Proximal femoral nail antirotation for the treatment of elderly patients with unstable intertrochanteric fractures

Xie Hai-ming1, Jin Zheng-shuai2, Li Yong1, Yan Xue-fei1, Yu Jian1   

  1. 1Department of Orthopedic Surgery, Shengze Branch of Jiangsu Provincial People’s Hospital, Suzhou 215228, Jiangsu Province, China;
    2Department of Orthopedic Surgery, Jiangsu Provincial People's Hospital, Nanjing 210000, Jiangsu Province, China
  • Received:2012-01-23 Revised:2012-02-26 Online:2012-08-26 Published:2012-08-26
  • Contact: Jin Zheng-shuai, Chief physician, Department of Orthopedic Surgery, Jiangsu Provincial People's Hospital, Nanjing 210000, Jiangsu Province, China jinzhengshuai@medmail.com.cn
  • About author:Xie Hai-ming, Associate chief physician, Department of Orthopedic Surgery, Shengze Branch of Jiangsu Provincial People’s Hospital, Suzhou 215228, Jiangsu Province, China oscar1629@126.com

摘要:

背景:股骨近端抗旋转髓内钉是在股骨近端髓内钉基础上设计的新型髓内固定系统,提高了抗旋转性和角度稳定性及抗切出能力。
目的:评价股骨近端抗旋转髓内钉置入治疗老年不稳定股骨转子间骨折的疗效。
方法:回顾性分析采用股骨近端抗旋转髓内钉置入治疗不稳定股骨转子间骨折56例患者的临床资料,对置入过程中细节、复位质量、螺旋刀片位置、置入后并发症和最终结果进行评价。
结果与结论:56例均采用闭合复位内固定,46例置入股骨近端抗旋转髓内钉过程顺利。置入后13个月:影像学评价显示骨折复位好44例,可12例;螺旋刀片位置42例位于股骨头中央,股骨头后下方12例,后上方2例;颈干角为(128±4.8)°。所有患者骨折在置入后3~6个月内愈合,50例患者肢体功能恢复到受伤前水平。无股骨颈切出和刀片进入髋臼并发症发生。说明股骨近端抗旋转髓内钉置入内固定适用于治疗老年不稳定股骨转子间骨折。

关键词: 髓内钉, 内固定, 股骨近端抗旋转髓内钉, 股骨转子间骨折, 螺旋刀片

Abstract:

BACKGROUND: Proximal femoral nail antirotation is a new designed intramedullary fixation system on the basis of the proximal femoral nails; it can improve the antirotation, angle stability and cut-resistant ability.
OBJECTIVE: To evaluate the curative effect of proximal femoral nail antirotation on the treatment of unstable intertrochanteric fractures in elderly patients.
METHODS: A retrospective analysis was preformed on the clinical data of 56 patients with unstable intertrochanteric fractures treated by proximal femoral nail antirotation. And details of surgery, quality of reduction, spiral blade position, postoperative complications and final results were evaluated.
RESULTS AND CONCLUSION: Fifty-six cases were treated with closed reduction and internal fixation, and 46 cases were treated with proximal femoral nail antirotation smoothly. After implanted for 13 months, the imaging evaluation showed that the healing of the fracture was good in 44 cases and satisfactory in 12 cases. Spiral blade position of 42 cases located in the central femoral head, and 12 cases located in the back upper place of the femoral head, 2 cases located in the back lower place of the femoral head and mean neck-shaft angle was (128±4.8)°. All patients were healed in 3-6 months. The limb functions of 50 patients were restored to pre-injury activity level. No occurrence of femoral neck cut off and the blade did not cut into the acetabulum. Proximal femoral nail antirotation is a successful treatment for unstable intertrochanteric fractures in elderly patients.

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