Application of modified fluoroscopy in the treatment of unstable intertrochanteric fracture of femur in elderly patients with PFNA in supine position
改良透视在非牵引床仰卧位PFNA治疗老年不稳定股骨粗隆间骨折中的应用

摘要

目的 探讨改良透视在非牵引床下仰卧位PFNA（proximal femoral nail antirotation）治疗老年不稳定股骨粗隆间骨折的应用疗效。方法 对我科2020年10月至2022年10月收治的30例老年股骨粗隆间骨折患者在非牵引床下仰卧位行PFNA术进行治疗。结果 术前准备到术毕节约了约20-30分钟，平均一台手术时间40-50分钟，大大降低了围术期风险。术后复查的X线片主钉位置良好，骨折复位良好，平均随访达到6-18月，28例患者骨折均得到愈合，并完全恢复日常生活活动，1例患者过早下床活动，骨质不愈合，发生了髋内翻，1例患者骨折未完全愈合，拄拐部分负重活动。结论 非牵引床下仰卧位PFNA治疗老年不稳定股骨粗隆间骨折更值得推广及基层医院的应用。

Abstract

Objective: To investigate the clinical effect of modified fluoroscopy in the treatment of unstable femoral intertrochanteric fractures in the elderly with proximal femoral nail antirotation (Pfna) under non-traction bed.
Methods from October 2020 to October 2022,30 elderly patients with femoral intertrochanteric fracture were treated with PFNA in supine position under non-traction bed. As a result, about 20-30 minutes were saved from preoperative preparation to the end of the operation, with an average of 40-50 minutes per operation, greatly reducing perioperative risk. All the patients were followed up for 6-18 months on average. The fractures of 28 patients were healed and their daily activities were resumed completely. One patient got out of bed too early, the bone did not heal and coxa vara occurred. One patient's fracture did not fully heal and he was walking with a heavy load.
Conclusion  : PFNA in supine position under non-traction bed for the treatment of unstable intertrochanteric fracture of femur in the elderly is more worthy of promotion and application in grass-roots hospitals.