股骨近端带锁髓内针对股骨粗隆间粉碎性骨折的疗效分析(1)
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[摘要] 目的 针对采用股骨近端带锁髓内针(proximal femoral nail，PFN)治疗股骨粗隆间粉碎性骨折进行术后疗效分析。 方法 对本院2007年6月～2011年6月205例股骨粗隆粉碎性骨折患者随机分组，分别行PFN、动力髋关节螺钉(dynamic hip screw，DHS)、γ钉、股骨近端锁定钢板(proximal femur locking plate，PFLP)治疗，观察其疗效。 结果 经术后6～23个月的随访，PFN优良率为98.1%，DHS优良率为87.2%，γ钉优良率为90.2%，PFLP优良率为84.9%，差异有统计学意义(P < 0.05)。 结论 PFN股骨近端髓内针对于股骨粉碎性骨折的作用是值得肯定和推广的，尤其适用于股骨粗隆间粉碎性骨折。
[关键词] 股骨近端带锁髓内针；股骨粗隆间；骨折；内固定
[中图分类号] R683.42 [文献标识码] A [文章编号] 1674-4721(2012)02(b)-0052-02
An analysis of effect on the crush fracture of femurs haft about proximal femoral nail application
KE Yangchun
Department of the Second Surgery, the People's Hospital of Hukou County in Jiangxi Province, Hukou 332500, China
[Abstract] Objective To observe and analysis proximal femoral nail (PFN) application and its effect in the crush fracture of femurs haft fracture. Methods Internal fixation was performed with PFN, dynamic hip screw (DHS), γ Nail or proximal femur locking plate (PFLP) for the 205 cases with crush fracture of femurs haft from June 2007 to June 2011 in our hospital who were randomly divided into different groups, the curative effect was observed. Results With the 6-23 months followed up after the operation, the excellent rate of PFN group was 98.1%, the excellent rate of DHS was 87.2%, the excellent rate of γ Nail was 90.2% and PFLP was 84.9%, there were significant difference among them (P < 0.05). Conclusion Proximal femoral nail is the best internal fixation for the operation of the crush fracture of femurs haft, especially in the minute femoral intertrachanteric fractures.
[Key words] Proximal femoral nail; Internal fixation; Femur intertrachanteric; Fracture
股骨为人体最长的管状骨，股骨骨折中最常见的就是股骨粗隆间骨折，随着年龄的增长，此类骨折的发病率也增高，并具有创伤性高、治疗期并发症多、愈后有损度大等特点，常规治疗有复位内固定和牵引治疗，并主张合并功能锻炼[1]。近来，手术复位内固定得到更多的推崇。其中，股骨近端带锁髓内针(proximal femoral nail，PFN)复位内固定法是手术中的理想首选。为此笔者为205例患者随机分别行4种手术方法治疗，并进行病后随访，记录统计，现总结如下：
1 资料与方法
1.1 一般资料
共收治205例患者，均为本院2007年6月～2011年6月住院治疗的股骨粗隆间粉碎性骨折患者，其中，女73例，男132例，年龄21～78岁，平均64岁。根据Evans判断分类，分别为EvansⅡ、Ⅲ、Ⅳ 型股骨粗隆间粉碎性骨折，左侧82例，右侧123例。平均随机分为4组按不同手术方法治疗，一组应用PFN治疗，二组应用动力髋关节螺钉(dynamic hip screw，DHS)治疗，三组应用γ钉治疗，四组应用股骨近端锁定钢板(proximal femur locking plate ......
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