PFNA治疗高龄重度骨质疏松股骨粗隆间骨折螺旋刀片切出后翻修1例

中国医药导刊 ›› 2023, Vol. 25 ›› Issue (3): 303-305.

PFNA治疗高龄重度骨质疏松股骨粗隆间骨折螺旋刀片切出后翻修1例

常育豪1，王会超2，刘又文2*

1.河南中医药大学，河南郑州 450000； 2.洛阳正骨医院(河南省骨科医院)髋部损伤二科，河南洛阳 471002

收稿日期:2022-08-12 修回日期:2022-11-16 出版日期:2023-03-28 发布日期:2023-03-28
基金资助:
国家自然科学基金面上项目(项目编号：82074472；项目名称：基于TLR4/MyD88/NF-k B信号通路探讨补肾活血法促M2极化干预激素性股骨头坏死的骨免疫机制)；河南省中医药科学研究专项课题（项目编号：2022ZY1124：项目名称：比较两种不同减压植骨方式治疗早中期股骨头坏死的临床疗效）

A Case of Revision of Spiral Blade Cut Out after Femoral Intertrochanteric Fracture Treated with PFNA in Elderly Patient with Severe Osteoporosis

1. Henan University of Chinese Medicine， Henan Zhengzhou 450000， China； 2.Department of Hip Injury， Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital)， Henan Luoyang 471002， China

Received:2022-08-12 Revised:2022-11-16 Online:2023-03-28 Published:2023-03-28
Contact: You-Wen -LIU E-mail:liuyouwen543@sina.com

摘要/Abstract

摘要： 目的：探讨高龄重度骨质疏松股骨粗隆间骨折患者的最佳治疗方案。方法：对我院收治的高龄重度骨质疏松股骨粗隆间骨折采用股骨近端防旋髓内钉( proximal femoral nail anti-rotation，PFNA) 内固定治疗后螺旋刀片切出的1例临床资料进行回顾性分析。结果：该病例为81岁女性，因摔倒致右髋部疼痛伴活动受限8 h入院。髋部X线检查示右股骨粗隆间骨折，遂行PFNA内固定术，术后5 d复查髋部X线示螺旋刀片切出，患者髋关节活动受限。应患者及家属要求，行螺旋刀片翻修术，术后复查髋部X线示右股骨粗隆间骨折对位对线良好，内固定装置位置好。结论：PFNA内固定适于骨质疏松不稳定型股骨粗隆间骨折患者，但对于重度骨质疏松且骨把持力较差的患者，需改进手术方法或考虑行髋关节置换术。

关键词: font-size:medium, ">股骨粗隆间骨折；重度骨质疏松；内固定器；股骨近端防旋髓内钉

Abstract: Objective：To explore the optimal treatment plan for femoral intertrochanteric fractures in elderly patients with severe osteoporosis. Methods：.The study retrospectively analyzed the clinical data of one case of spiral blade cut out after proximal femoral nail anti-rotation (PFNA) internal fixation in an elderly femoral intertrochanteric fracture patient with severe osteoporotic in our hospital. Results：The patient was an 81-year-old female who was admitted to the hospital with right hip pain and limited movement for 8 h due to a fall. The hip X-ray showed a right femoral intertrochanteric fracture， so PFNA internal fixation was performed， and the hip X-ray was reexamined 5 d after the operation， which showed spiral blade cut out and the patient had limited hip movement. At the request of the patient and family， a revision of the spiral blade was performed， and the postoperative hip X-ray showed good alignment of the right femoral intertrochanteric fracture and good position of the internal fixation device. Conclusion：PFNA internal fixation is suitable for patients with osteoporotic unstable intertrochanteric fractures， but for patients with severe osteoporosis and poor bone grip， improved surgical methods or hip arthroplasty should be considered.

Key words: font-size:medium, ">Femoral intertrochanteric fracture； Severe osteoporosis； Internal fixator； Proximal femoral nail anti-rotation

中图分类号:

常育豪, 王会超, 刘又文. PFNA治疗高龄重度骨质疏松股骨粗隆间骨折螺旋刀片切出后翻修1例[J]. 中国医药导刊, 2023, 25(3): 303-305.

CHANG Yuhao, WANG Huichao, LIU Youwen. A Case of Revision of Spiral Blade Cut Out after Femoral Intertrochanteric Fracture Treated with PFNA in Elderly Patient with Severe Osteoporosis[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(3): 303-305.

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