Suckel A, Münst P, Mocke U
Orthopädische Universitätsklinik mit Poliklinik, Tübingen.
Z Orthop Ihre Grenzgeb. 2006 Sep-Oct;144(5):532-8. doi: 10.1055/s-2006-942166.
The proximal femur nail (PFN) and the gliding nail (GLN) are two modern procedures available for intramedullary osteosynthesis of proximal extra-articular femur fractures; they allow a rotationally stable fixation of the proximal fragment. In a comparative analysis of complications, both methods should be evaluated.
A comparative analysis of both procedures is presented in a prospective clinical study design. The treatment of 240 consecutive patients (124 PFN/116 GLN) with an average follow-up term of 10.2 months is analysed.
Both PFN and GLN give rise to head perforations (4.8% and 2.6%), dislocations of material (0.8% and 0%), intraoperative femoral shaft fractures (0.8% and 2.6%), pseudarthrosis (0% and 0.9%) and fractures of material (0.8% and 0%) in the way of complications as well as wound-healing impairments (9.7 % and 5.2 %) and iatrogenic complications such as false placement of the osteosynthesis material and errors in reposition (0.8% and 4.3%).
The gliding nail osteosynthesis yields a more favourable complication profile with regard to specific osteosynthesis-caused complications (6.0%) and wound-healing impairments (5.2%) in comparison with the PFN osteosynthesis (7.3% and 9.7%, respectively). Especially the cut-out rate of the GLN (2.6%) is lower than that of the PFN (4.8%).
股骨近端髓内钉（PFN）和滑动钉（GLN）是用于股骨近端关节外骨折髓内固定的两种现代手术方法；它们能实现近端骨折块的旋转稳定固定。在一项并发症的对比分析中，应对这两种方法进行评估。
在一项前瞻性临床研究设计中对这两种手术方法进行对比分析。分析了连续240例患者（124例采用PFN/116例采用GLN）的治疗情况，平均随访期为10.2个月。
PFN和GLN都会引发并发症，如股骨头穿孔（分别为4.8%和2.6%）、内植物移位（分别为0.8%和0%）、术中股骨干骨折（分别为0.8%和2.6%）、骨不连（分别为0%和0.9%）以及内植物断裂（分别为0.8%和0%），还有伤口愈合障碍（分别为9.7%和5.2%）以及医源性并发症，如内固定材料放置错误和复位错误（分别为0.8%和4.3%）。
与PFN内固定术相比（分别为7.3%和9.7%），滑动钉内固定术在特定的内固定引起的并发症（6.0%）和伤口愈合障碍（5.2%）方面具有更有利的并发症情况。尤其是GLN的穿出率（2.6%）低于PFN（4.8%）。
