使用股骨近端抗旋转钉-II(PFNA-II)治疗老年转子间骨折的临床和功能疗效

Dr. Sameer Mohammad Zargar, Dr. Tajamul Hussain Nehvi, Dr. Asif Nazir Baba, Dr. Mohd. Ishaq Ganaie
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摘要

简介股骨转子间骨折占髋关节周围骨折的近一半,众所周知,股骨转子间骨折与长期功能障碍、入住疗养院和死亡率增加有关。股骨转子间骨折的常规手术可使患者早日康复,加快康复速度。在治疗转子间骨折时,如何选择植入物一直是一个争论不休的话题,尤其是随着多年来各种装置的发展。本研究旨在评估老年患者使用股骨近端抗旋转钉 II(PFNA-II)治疗转子间骨折的临床和功能效果。研究方法本研究对 30 例老年股骨转子间骨折患者使用股骨近端钉抗旋转 II 型(PFNA-II)的临床和功能结果进行了评估。检查时注意是否存在压痛、畸形、肢体长度差异和活动范围。借助哈里斯髋关节评分对功能结果进行评估。结果完全负重的平均时间为 9.5 周(6-12 周不等)。在最后的随访中,半数患者表示髋部无疼痛,11 例患者有轻微的偶发性疼痛。随访6个月时的平均活动范围为226度(175-270度之间)。哈里斯髋关节评分的平均值为 90.6(范围为 85-100)。在这项研究中,根据哈里斯髋关节评分,所有患者均被评为优或良:本研究结果表明,对转子间骨折的老年患者应用 PFNA 可获得满意的效果和临床结果,且放射学并发症发生率较低。
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Clinical and functional outcome of inter-trochanteric fractures in the elderly patients using Proximal Femoral Nail Anti-rotational-II (PFNA-II)
Introduction: Intertrochanteric fractures of the femur constitute nearly half of all the fractures around the hip and are known to be associated with long-term functional impairment, nursing home admission and increased mortality. Intertrochanteric fractures are routinely operated, which enables early recovery and faster rehabilitation of the patient. The choice of implant used in the management of intertrochanteric fractures has been a subject of debate, especially with the development of various devices over the years. The aim of present study was to evaluate clinical and functional outcome of intertrochanteric fractures in elderly patients using proximal femoral nail anti-rotation-II (PFNA-II). Methods: The present study was carried out 30 patients to evaluate clinical and functional outcome of intertrochanteric fractures in elderly patients using proximal femoral nail anti-rotation-II (PFNA-II). On examination, presence of any tenderness, deformity, limb length discrepancy and range of motion were noted. Functional outcomes were assessed with the help of Harris Hip Score. Results: The mean time to full weight bearing was calculated to be 9.5 (range 6-12) weeks. At final follow-up, half of the patients reported no pain in the hip while 11 cases had slight, occasional pain The mean time to union in our study was calculated to be 11.3 weeks. The mean range of motion at 6 months follow-up was 226 (range 175-270) degrees. The average Harris hip score was 90.6 (range 85-100). In this study, according to Harris hip score all patients were graded excellent or good scores Conclusion: The present findings suggest that PFNA applied in elderly patients with inter-trochanteric fracture can get satisfactory effects, clinical outcome and a lower radiological complication rate.
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