Park Jung Ho, Lee Yong Seuk, Park Jong Woong, Wang Joon Ho, Kim Jae Gyoon
Department of Orthopedic Surgery, College of Medicine, Korea University, Ansan, Korea.
Orthopedics. 2010 Feb;33(2):81-5. doi: 10.3928/01477447-20100104-11.
The goal of this study was to compare treatment outcomes of screw proximal femoral nails and helical proximal femoral nails and to investigate the effectiveness of helical proximal femoral nails for the treatment of intertrochanteric fractures. Forty patients with intertrochanteric fractures were treated at our institution between January 2005 and January 2007, with a minimum follow-up of 1.5 years. Seventeen patients were treated with screw proximal femoral nails (mean patient age, 67 years; age range, 45-89 years; men:women ratio, 3:14), and 23 were treated with helical proximal femoral nails (mean patient age, 74 years; age range, 64-91 years; men:women ratio, 6:17). We evaluated mean operation time, amount of bleeding, time to ambulation, average union period, changes in neck shaft angle, and complications, and performed radiographic reviews, telephone interviews, and direct contact interviews at an outpatient clinic. We evaluated postoperative function and mobility using social function scores and mobility scores.Helical proximal femoral nails produced better results in terms of social function scores, mobility scores, and complication rates with statistical significance. No significant differences were found between the 2 nails in terms of mean operation time, amount of bleeding, average union period, time to ambulation, or neck shaft angle changes. Screw proximal femoral nails and helical proximal femoral nails are suitable implants for intertrochanteric fractures, but helical proximal femoral nails are better in terms of functional aspects and complication rates.
本研究的目的是比较股骨近端螺旋刀片抗旋髓内钉和股骨近端锁定钢板的治疗效果，并探讨股骨近端螺旋刀片抗旋髓内钉治疗股骨转子间骨折的有效性。2005年1月至2007年1月期间，我们机构对40例股骨转子间骨折患者进行了治疗，最短随访时间为1.5年。17例患者采用股骨近端锁定钢板治疗（患者平均年龄67岁；年龄范围45 - 89岁；男女比例为3:14），23例患者采用股骨近端螺旋刀片抗旋髓内钉治疗（患者平均年龄74岁；年龄范围64 - 91岁；男女比例为6:17）。我们评估了平均手术时间、出血量、下地行走时间、平均愈合时间、颈干角变化及并发症情况，并在门诊进行了影像学复查、电话访谈和直接接触访谈。我们使用社会功能评分和活动能力评分评估术后功能和活动能力。股骨近端螺旋刀片抗旋髓内钉在社会功能评分、活动能力评分及并发症发生率方面取得了更好的结果，具有统计学意义。在平均手术时间、出血量、平均愈合时间、下地行走时间或颈干角变化方面，两种内固定物之间未发现显著差异。股骨近端锁定钢板和股骨近端螺旋刀片抗旋髓内钉都是治疗股骨转子间骨折的合适植入物，但股骨近端螺旋刀片抗旋髓内钉在功能方面和并发症发生率方面表现更佳。
