Lv Chaoliang, Fang Yue, Liu Lei, Wang Guanglin, Yang Tianfu, Zhang Hui, Song Yueming
Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Orthopedics. 2011 May 18;34(5):351. doi: 10.3928/01477447-20110317-26.
The proximal femoral nail antirotation system was introduced by the Arbeitsgemeinschaft fur Osteosynthesfragen/Association for the Study of Internal Fixation (AO/ASIF) in 2003 and is suitable for treating unstable trochanteric fractures. However, proximal femoral nail antirotation was designed according to the geometric proportions of the White population, and it is known that important differences exist between Asians and Americans with regard to femoral geometry. Reports of serious postoperative complications also exist when used for the elderly Asian population. Therefore, geometrical mismatch between proximal femoral nail antirotation and the femora of Asians has led the AO/ASIF to design a new proximal femoral nail antirotation for Asia with adapted sizes and geometry. This article reports early clinical results of using proximal femoral nail antirotation for Asians in 84 consecutive patients to stabilize unstable trochanteric fractures (AO classification, 31.A2 and A3). Patients were followed up for an average 8 months (range, 4-11 months). Intraoperative and postoperative complications, surgical details, and outcome measurements were evaluated. Fractures were treated by closed reduction and intramedullary fixation. The proximal femoral nail antirotation Asia position was ideal in 80 cases (95%). No patients showed complication related to the mismatch between the nail and femora. The mean time to bone healing was 14 weeks. Functionally, 90% of the patients regained pretrauma mobility. According to the Harris hip scoring system, 63 patients (78%) had an excellent or good outcome. The new proximal femoral nail antirotation Asia yields better results in the treatment of unstable trochanteric fractures in elderly patients by closely matching Asian femoral anatomy and thereby reducing complications related to the implants.
股骨近端抗旋髓内钉系统由骨科学研究协会/内固定研究协会（AO/ASIF）于2003年推出，适用于治疗不稳定型股骨转子间骨折。然而，股骨近端抗旋髓内钉是根据白种人的几何比例设计的，众所周知，亚洲人和美国人在股骨几何形状方面存在重要差异。该髓内钉用于亚洲老年人群时也有严重术后并发症的报道。因此，股骨近端抗旋髓内钉与亚洲人股骨之间的几何形状不匹配，促使AO/ASIF设计了一种尺寸和几何形状更适配的亚洲版新型股骨近端抗旋髓内钉。本文报告了连续84例使用亚洲版股骨近端抗旋髓内钉治疗不稳定型股骨转子间骨折（AO分类，31.A2和A3）患者的早期临床结果。患者平均随访8个月（范围4 - 11个月）。评估了术中及术后并发症、手术细节和结果测量指标。骨折采用闭合复位和髓内固定治疗。80例（95%）患者的亚洲版股骨近端抗旋髓内钉位置理想。没有患者出现与髓内钉和股骨不匹配相关的并发症。平均骨愈合时间为14周。功能方面，90%的患者恢复了伤前的活动能力。根据Harris髋关节评分系统，63例（78%）患者结果为优或良。新型亚洲版股骨近端抗旋髓内钉通过紧密匹配亚洲人股骨解剖结构，在治疗老年患者不稳定型股骨转子间骨折方面取得了更好的效果，从而减少了与植入物相关的并发症。
