Saiseikai Kumamoto Hospital, Department of Orthopaedic Surgery, 5-3-1 Chikami, Kumamoto City, Japan.
Injury. 2011 Sep;42 Suppl 4:S22-7. doi: 10.1016/S0020-1383(11)70008-0.
The aim of this study was to investigate the outcome of 352 (71 males) patients with trochanteric fractures that were treated with the TARGON® PF nail. The mean age was 83 years. According to the Jensen classification, there were 35 cases in type 1,94 cases in type 2,75 in type 3,63 in type 4 and 85 in type 5. Postoperative all patients were allowed to fully weight bear from the first postoperative day. Clinical and radiological data were collected at regular time intervals. The average waiting time to surgical reconstruction for the 352 cases was 3.5 days (1-7). The mean length of hospital stay was 14 days (5-22). The operative times ranged from 11 to 125 minutes with an average time of 32 minutes. Fifty percent of the patients regained their mobility to their pre-injury level at the final follow up. Out of 310 patients (88%) who were available for radiographie assessment, all fractures united except one case. 300 (85%) of the lag screws were placed in the inferior area in the anteroposterior view and in the central area in the lateral view (IM), which is regarded as the optimal position. The lag screws back-slided between 0 and 19 mms with an average of 6 mm. Sliding distance of the lag screw for over 10 mm was seen in 42 cases (13%). Varus collapse of the femoral head-and-neck greater than 10° was observed in 6 cases. Postoperative complications developed in 6 cases (1.7%), including wound infection in two cases, and secondary fracture at the subtrochanteric region, nonunion, back-out of the guiding sleeve and medial perforation of the lag screw, each in one case. The presented case series indicates that the TARGON® PF system is an effective and safe internal fixation device for trochanteric proximal femoral fractures. Further, prospective comparative evidence regarding the use of this system is needed to analyse and validate the presented clinical impression of our centre.
本研究旨在探讨 352 例（71 例男性）采用 TARGON®PF 钉治疗的转子间骨折患者的治疗效果。患者平均年龄为 83 岁。根据 Jensen 分类法，1 型 35 例，2 型 94 例，3 型 75 例，4 型 63 例，5 型 85 例。术后所有患者均在术后第一天开始完全负重。定期收集临床和影像学数据。352 例患者的平均手术等待时间为 3.5 天（1-7 天）。平均住院时间为 14 天（5-22 天）。手术时间从 11 分钟到 125 分钟不等，平均时间为 32 分钟。50%的患者在最终随访时恢复到受伤前的活动水平。310 例（88%）可进行影像学评估的患者中，所有骨折均愈合，除 1 例外。300 例（85%）的拉力螺钉在前后位视图中位于下区，在侧位视图中位于中央区（IM），这被认为是最佳位置。拉力螺钉向后滑动 0 至 19 毫米，平均 6 毫米。42 例（13%）的拉力螺钉滑动距离超过 10 毫米。6 例（1.7%）观察到股骨头颈内翻大于 10°的塌陷。6 例（1.7%）术后发生并发症，包括 2 例切口感染，1 例转子下区再骨折，1 例骨不连，1 例导套退出，1 例拉力螺钉内侧穿孔。本病例系列表明，TARGON®PF 系统是治疗转子间股骨近端骨折的一种有效、安全的内固定装置。此外，还需要前瞻性的比较证据来分析和验证我们中心的临床印象。
