| 摘要: |
| ［摘要］ 目的 分析股骨转子间骨折股骨近端防旋髓内钉（PFNA）内固定术失败行人工髋关节置换的疗效。方法 回顾性分析2014年10月至2019年1月人工髋关节置换术治疗21例股骨转子间骨折PFNA内固定术失败患者，行全髋关节置换8例，股骨头置换13例。记录手术时间、术中出血量、术后引流量、并发症、Harris评分及优良率。随访通过X线片观察假体生存情况。结果 21例PFNA手术失败患者行关节置换平均手术时间为（120.242±35.623）min，术中出血量为（520.252±212.363）ml，术后引流量为（320.362±180.248）ml。术中发生医源性骨折2例，术后发生切口浅表感染1例，所有患者均无深静脉血栓。获得随访19例，随访时间为1～3年。所有患者X线片未见假体松动、断裂，随访髋关节Harris评分及优良情况较术前明显改善（P<0.05）。结论 人工髋关节置换是治疗股骨转子间骨折PFNA内固定术失败可行的补救治疗，需要严格把握手术指征，术前充分评估和术中轻柔操作有利于降低并发症发生率。 |
| 关键词: 股骨转子间骨折 股骨近端防旋髓内钉 人工髋关节置换 |
| DOI：10.3969/j.issn.1674-3806.2022.06.12 |
| 分类号:R 684.7 |
| 基金项目: |
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| Analysis of the efficacy of hip arthroplasty in treatment of femoral intertrochanteric fractures after PFNA internal fixation failures |
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LI Fu-lin, YIN Dong, HUANG Yu, et al.
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Department of Orthopaedics, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To analyze the efficacy of hip arthroplasty in treatment of femoral intertrochanteric fractures after proximal femoral nail antirotation(PFNA) internal fixation failure. Methods A retrospective analysis was performed on 21 patients with femoral intertrochanteric fractures after PFNA internal fixation failures who received hip arthroplasty treatment from October 2014 to January 2019, including 8 cases of total hip arthroplasty and 13 cases of femoral head replacement. The operative time, intraoperative blood loss, postoperative drainage volume, complications, Harris score and excellent and good rate were recorded. The survival of the prostheses was observed by X-ray. Results The average operative time of hip arthroplasty in the 21 patients with PFNA failed operation was (120.242±35.623)min, and their intraoperative blood loss and postoperative drainage volume were (520.252±212.363)ml and (320.362±180.248)ml, respectively. Iatrogenic fracture occurred in 2 cases during operation and superficial wound infection occurred in 1 case after operation, but no deep vein thrombosis(DVT) was found in all the patients. Nineteen cases were followed up for 1 to 3 years. At the last follow-up, no loosening or fracture of the prostheses was found in the X-ray films of all the patients. Compared with those before operation, Harris score and excellent and good condition of the hip joints were significantly improved after follow-up(P<0.05). Conclusion Hip arthroplasty is a feasible remedial treatment for the failure of PFNA internal fixation of femoral intertrochanteric fractures. It needs to strictly understand the operation indications. Fully evaluating the disease preoperatively and gently operating on the patient intraoperatively are conducive to reducing the incidence of complications. |
| Key words: Femoral intertrochanteric fractures Proximal femoral nail antirotation(PFNA) Hip arthroplasty |
