Objective To explore the clinical effects of proximal femoral nail anti-rotation K ( PFNA- II ) in the treatment of elderly unstable femoral intertrochanteric fracture. Methods Totally 46 elderly patients with unstable femoral intertrochanteric fractures were treated by PFNA-II from February 2009 to October 2010. The patients received manipulative traction and closed reduction. Results The mean operation time in this series was 60 min (45 - 100 min) , during which 80 - 144 ml (mean, 120 ml) blood loss was measured. The patients were discharged from hospital 5-14 days after the operaiton ( mean, 9 days) , after that 42 of them received a follow-up for 4 - 18 months (mean, 8 months) , which showed fracture reunion in 10 weeks to 6 months (mean, 13 weeks) without occurrence of varus deformity, hardware loosening or hardware cutting. According to Harris Hip score, 26 cases achieved excellent results, 10 were good, 4 were fair and 2 were poor. The excellent and good rate of the hip joint function was 85.7% (36/42). Conclusions It is an ideal method to treat unstable femoral intertrochanteric fracture with PFNA- II in elderly patients. The procedure is convenient and the fixation is stable.%目的 探讨亚洲型股骨近端抗旋髓内钉(proximal femoral nail anti-rotationⅡ,PFNA-Ⅱ)治疗老年不稳定股骨转子间骨折的临床效果. 方法 2009年2月～2010年10月对46例老年不稳定股骨转子间骨折采用闭合牵引复位,小切口置入PFNA-Ⅱ. 结果 手术时间45～100 min,平均60 min.出血80 ～440 ml,平均120 ml.术后住院5～14d,平均9d.42例随访4～18个月,平均8个月:骨折全部愈合,愈合时间10周～6个月,平均13周;未出现髋内翻,内固定物失效及切割现象;按Harris髋关节功能评分,优26例,良10例,中4例,差2例,优良率85.7％ (36/42). 结论 PFNA-Ⅱ内固定具有操作简单、固定可靠的特点,是目前治疗老年不稳定股骨转子间骨折理想的内固定材料.
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