[1]曹源范吉星崔增桢杨钟玮吕扬田耘周方**.新型髓内固定系统股骨近端通用髓内钉治疗老年患者股骨转子间骨折的疗效[J].中国微创外科杂志,2025,01(6):329-334.
　Cao Yuan,Fan Jixing,Cui Zengzhen,et al.Efficacy of a New Intramedullary Fixation System Proximal Femoral Universal Nail in the Treatment of Intertrochanteric Femoral Fractures in Elderly Patients[J].Chinese Journal of Minimally Invasive Surgery,2025,01(6):329-334.
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新型髓内固定系统股骨近端通用髓内钉治疗老年患者股骨转子间骨折的疗效()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2025年6期
页码:
329-334
栏目:
临床论著
出版日期:
2025-06-25

文章信息/Info

Title:
Efficacy of a New Intramedullary Fixation System Proximal Femoral Universal Nail in the Treatment of Intertrochanteric Femoral Fractures in Elderly Patients
作者:
曹源范吉星崔增桢杨钟玮吕扬田耘周方**
(北京大学第三医院骨科骨与关节精准医学教育部工程研究中心，北京100191)
Author(s):
Cao Yuan;  Fan Jixing;  Cui Zengzhen;  et al.
Department of Orthopedics, Peking University Third Hospital; Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing 100191, China
关键词:
股骨转子间骨折; 老年患者; 股骨近端通用髓内钉; 内固定失效
Keywords:
Intertrochanteric femoral fractures; Elderly patients; Proximal femoral universal nail; Failure of internal fixation
文献标志码:
A
摘要:
目的探讨新型髓内固定系统股骨近端通用髓内钉(proximal femoral universal nail，PFUN)治疗老年患者急性单侧股骨转子间骨折的疗效。方法2022年1月~2024年1月我科对200例老年患者急性单侧股骨转子间骨折采用闭合牵引复位，小切口置入PFUN，术后采用统一康复计划，末次随访采用髋关节Harris评分系统进行功能评价。结果手术时间25~182 min，中位数63.0 min。术中出血量10~750 ml，中位数50.0 ml。术中输血例数(悬浮红细胞)40例(20%)。术后住院时间1~15 d，(4.0±1.9)d。术后股骨颈干角116.7°~140.1°，132.4°±5.5°。术后1 d骨折复位质量：优140例，可54例，差6例。并发症13例，其中切口浅表感染2例，经定期切口换药及抗生素治疗痊愈；下肢深静脉血栓形成8例，经低分子肝素抗凝治疗后好转；肺炎2例，泌尿系感染1例，经专科治疗后痊愈或好转。200例术后1个月髋关节X线正侧位示骨折线模糊，骨折断端骨痂生成，无内固定失效；术后3个月无内固定失效；术后6个月骨折均达到愈合，无内固定失效。200例随访12~29个月，（16.1±2.7）月。1例出现内固定失效，头颈螺钉切割，行内固定取出、髋关节置换手术，术后恢复可。末次随访髋关节Harris评分70~94分，(88.8±2.8)分，优103例，良92例，可5例，优良率97.5%(195/200)。结论PFUN能够有效治疗老年患者股骨转子间骨折，具有固定可靠、术后恢复快、内固定失效率低等特点，尤其适合于合并内、外侧壁骨折的不稳定型患者。
Abstract:
ObjectiveTo evaluate the efficacy of proximal femoral universal nail (PFUN), a new type of intramedullary fixation system, in the treatment of acute unilateral intertrochanteric femoral fracture in elderly patients.MethodsFrom January 2022 to January 2024, 200 patients with acute unilateral femoral intertrochanteric fracture were treated in our department. After closed traction reduction, PFUN was implanted with small incisions. Unified rehabilitation plan was adopted after surgery. The functional evaluation was performed by using the Harris hip score system at the last followup. ResultsThe operation time was 25-182 min (median, 63.0 min). The intraoperative blood loss was 10-750 ml (median, 50.0 ml). Intraoperative blood transfusion (suspension of red blood cells) was required in 40 cases (20%). The postoperative hospital stay was 1-15 d (mean, 4.0±1.9 d). The postoperative femoral neckshaft angle was 116.7°-140.1° (mean, 132.4°±5.5°). The quality of fracture reduction on the first day after surgery showed 140 cases as excellent, 54 cases acceptable, and 6 cases poor. Complications occurred in 13 cases, including superficial wound infection in 2 cases, who were cured by regular wound dressing change and antibiotic treatment, lower extremity deep vein thrombosis in 8 cases, who were given low molecular weight heparin anticoagulation treatment until improvement, pneumonia in 2 cases and urinary tract infection in 1 case, who were cured or improved after specialist treatment. At one month after surgery, the hip joint Xray showed blurred fracture lines, callus formation at the fracture site, and no internal fixation failure. There was no internal fixation failure within 3 months after surgery. At six months after surgery, all fractures achieved healing without any failure of internal fixation. All the 200 cases were followed up for 12-29 months (mean, 16.1±2.7 months).One case experienced internal fixation failure, and underwent head and neck screw resection, internal fixation removal and hip replacement. At the last followup, the postoperative recovery was satisfactory. The Harris score of hip joint was 70-94 points (mean, 88.8±2.8 points), including 103 cases as excellent, 92 cases good, and 5 cases fair, with an excellent and good rate of 97.5% (195/200).ConclusionPFUN is effective in the treatment of intertrochanteric femoral fractures in elderly patients, with reliable fixation, rapid postoperative recovery, and low failure rate of internal fixation, especially suitable for unstable cases with internal or external wall fractures.

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备注/Memo

备注/Memo:
基金项目：国家重点研发计划（2023YFC2508804）；首都卫生发展科研专项（2022-2-4096）；北京大学第三医院创新转化基金科创研发（BYSYZHKC117）**通讯作者，Email：zhouf@bjmu.edu.cn
更新日期/Last Update: 2025-08-20