【摘 要】
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Objective: To retrospective analysis the clinical outcome of emergency treatment to senile intertrochanteric fracture with proximal femoral nail antirotation (PFNA).Methods: From September 2008 to mar
【机 构】
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Department of Orthopaedic Surgery,West China Hospital of Sichuan University,Chengdu 610041.China
【出 处】
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海峡两岸骨科专委会学术交流会、抗震救灾五周年学术研讨会暨第十届华西国际骨科论坛
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Objective: To retrospective analysis the clinical outcome of emergency treatment to senile intertrochanteric fracture with proximal femoral nail antirotation (PFNA).Methods: From September 2008 to march 2009, 35 senile patients with intertrochanteric fracture, age from 65 to 92 years old with an average years of 76.5 years, were treated with the PFNA within 24 hours after injury, among whom there were 10 type Ⅰ,19 type Ⅱ,6 type Ⅲ according to reforming Evans-Johnson classification and all patients complicated with osteoporosis.19 cases were complicated with internal medicine diseases and there were 9 type Ⅰ, 14 type Ⅱ ,8 type Ⅲ,4 type Ⅳ according to ASA classification.Results: The operative time ranged 45-73 minutes with an average time of 57.6 minutes, the volume of blood loss ranged 50-120 mL with an average volume of 77.5 rnL, getting out of bed time ranged 2-4 days with an average time of 3.5 days; the length of stay ranged 4-7 days with an average days of 5.3 weeks.the weight bearing time ranged 10-14 weeks with an average time of 12.8 weeks.During hospitalization period, there was no intra-operative femoral fractures、 regional or deep infection、 hypostatic pneumonia、 urinary tract infection and bed-sore except for 2 urine retention.All cases were followed up with an average time of 12.3 months, and achieved bone healing within 15-18 weeks with an average time of 16.6 weeks.No complications such as delay healing, coxa vara or coxa valga, cut-out and screw extraction occurred and only 2 cases occured trochanter bursitis because of thin body and the longer end of the antirotation nail.According to the Harris criterion for evaluation, the results were excellent in 21 cases, good in 9 cases and fair in 5 cases, the excellent and good rate was 85.7%.Conclusion: The emergency treatment of senile intertrochanteric fracture with proximal femoral nail antirotation has the advantages of micro invasion, easy-to-operate, less blood loss, shorter length of stay, less complications and the preliminary clinical effect was satisfied.
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