| 李鹏 宋静 王明昊 李雪波 刘锁利 万建设 郭晓东.尖顶距在股骨近端抗旋转髓内钉治疗股骨近端骨折中的应用[J].,2014,14(33):6517-6519 |
| 尖顶距在股骨近端抗旋转髓内钉治疗股骨近端骨折中的应用 |
| Application of TAD on the Treatment of Proximal Femoral Fracturesby the Proximal Femoral Nail Antirotation |
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| DOI： |
| 中文关键词: 股骨近端抗旋转髓内钉 尖顶距 股骨近端骨折 |
| 英文关键词: Proximal femoral nail antirotation(PFNA) Tip-apex distance(TAD) Proximal femoral fractures |
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| 中文摘要: |
| 目的：探讨尖顶距在股骨近端抗旋转髓内钉治疗股骨近端骨折临床效果中的作用和意义，为骨外科手术疗效的评价提供可
借鉴的方法。方法：对2006 年8 月-2007 年10 月期间在我院接受PFNA 治疗的32 例股骨近端骨折患者的临床资料进行回顾性
分析。根据AO/ASIF国际内固定研究学会标准对骨折进行分类，应用术中和术后即刻X 光射线照片对骨折复位情况、远端锁定
类型和股骨头内刀片位置进行记录。患者术后常规X 光照片观察切出情况，用Oxford 髋关节评分系统评价临床疗效。结果：研究
期间共有37 例PFNA 植入，纳入本研究的共32例，27 例获得随访。其中，3 例切出（2 例内侧穿孔和1 例内侧塌陷）TAD 小于20
mm。4 例植入相关股骨骨折，2 例不愈合，1 例复位失败。结论：PFNA 是治疗股骨近端不稳定型骨折的有效装置。我们认为TAD
应尽量＜20 mm 或＞30 mm以避免股骨头穿透。 |
| 英文摘要: |
| Objective:To explore the application and significance of TAD on the treatment of proximal femoral fractures by
PFNA in order to make a reference for clinical research.Methods:A retrospective analysis was performed about the clinical data of 32
patients with proximal femoral fractures who were treated by PFNA in our hospital from August 2006 to October 2007. The international
standards for the study of internal fixation with AO/ASIF was used to classify the types of fractures, the intraoperative and postoperative
immediate X-ray photographs of fracture were applied to record the distal locking blade position, the type and the femoral head. The
conventional X-ray was performed to observe the postoperative cut out, and the Oxford hip grading system was meant to evaluate the
clinical effect.Results:32 patients were enrolled in the study among which there were 27 cases followed up. 3 cases presented the cut out
(2 cases of medial perforation and 1 case of medial collapse) with the TAD<20 mm. 4 cases were implanted into the related femoral
fractures, 2 cases not healing, and 1 case of reset failed.Conclusion:It is suggested the PFNA should be an effective device for the
treatment of unstable proximal femoral fractures. However, the blade distance should be in TAD<20 mm or TAD>30 mm so as to avoid
the penetration of femoral. |
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