Lu Jian-wei, Song Hong-pu, Yu Lei-jun, Yu Zheng, Liu Hong
Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China.
Zhongguo Gu Shang. 2009 Oct;22(10):785-6.
To evaluate the clinical effect of minimally invasive Trochanteric Antegrade Nail (TAN) for the treatment of intertrochanteric fractures of femur in elder.
From January 2005 to June 2008, 80 patients with intertrochanteric fractures of femur were treated with minimally invasive fixation of Trochanteric Antegrade Nail. There were 16 males and 64 females with an average age of 75 years ranging from 65 to 93 years. According to Evans classification, there were 8 cases of type I, 32 of type II, 30 of type III, 6 of type IV and 4 of type V. After the operation of minimally invasive Trochanteric Antegrade Nail fixation,patients begun to do the continuous passive motion (CPM) and active motion of the injured hip joint and knee joint.
All patients were followed from 5 to 18 months with an average of 10 months. All factures were healing in time from 10 to 14 weeks with none screw breakage. Proximal screw exiting out about 0.5 cm occurred in 3 patients without obvert symptom. Three patients appeared lower limb deep venous thrombosis and were cured with medicine. According to the scales of Sanders, pain score was 9.08 +/- 1.19, ambulation score 8.85l +/- 1.09, function score 9.10 +/- 1.27, muscle strength score 9.13 +/- 1.18, daily life score 8.91 +/- l.07, X-ray evaluation score 9.34 +/- 1.09, so as the results were excellent in 56 cases, good in 20, poor in 4.
With the advantage of mini-invasion, operative convenience and stable fixation, minimally invasive TAN fixation is an effective method for intertrochanteric fractures in elder.
评估微创股骨转子顺行髓内钉（TAN）治疗老年股骨转子间骨折的临床效果。
2005年1月至2008年6月，80例股骨转子间骨折患者接受了微创股骨转子顺行髓内钉固定治疗。其中男性16例，女性64例，平均年龄75岁，年龄范围65至93岁。根据Evans分型，I型8例，II型32例，III型30例，IV型6例，V型4例。微创股骨转子顺行髓内钉固定术后，患者开始进行患侧髋关节和膝关节的持续被动运动（CPM）及主动运动。
所有患者均获随访5至18个月，平均10个月。所有骨折均在10至14周内及时愈合，无螺钉断裂。3例患者近端螺钉穿出约0.5 cm，但无明显症状。3例患者出现下肢深静脉血栓形成，经药物治疗治愈。根据Sanders评分标准，疼痛评分9.08±1.19，行走评分8.85±1.09，功能评分9.10±1.27，肌力评分9.13±1.18，日常生活评分8.91±1.07，X线评估评分9.34±1.09，结果优56例，良20例，差4例。
微创TAN固定具有微创、手术操作简便、固定稳定的优点，是治疗老年股骨转子间骨折的有效方法。
