Xie Hui, Wang Zhan, Zhang Junji, Xu Langhai, Chen Bao
Department of Orthopaedics, Jiaxing No. 2 Hospital, Jiaxing University, Jiaxing 314001, China.
Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopaedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China.
Oncotarget. 2017 Jul 31;8(47):82700-82704. doi: 10.18632/oncotarget.19754. eCollection 2017 Oct 10.
To compare the clinical results of DHLP (Dynamic hip locking plates) and PFNA-IIs (proximal femoral nails anti-rotation-Asia) for treating intertrochanteric femur fracture (IFF) with lateral wall fractures in the elder patients and provide a rationale for the clinical practice.
A retrospective analysis of 43 patients of IFF with lateral wall fractures was performed from December 2009 to April 2015. Intraoperative variables and postoperative complications and function were compared between the two groups.
17 cases were treated by DHLPs, and 26 treated by PFNA-IIs. Patients were followed up from 6 to 16 months with an average of 11 months. Both the groups were comparable for demographic data before surgery. The PFNA-II group had less operation time, time of full weight bearing and healing time of fracture, but larger blood loss in comparison with the DHLP group (<0.05). Additionally, internal fixation failure was significantly more in the DHLP group than in the PFNA-II group. The mean HHS and the rate of good-to-excellent in the PFNA-II group was significantly higher than that in the DHLP group both in third month after surgery (<0.05).
PFNA-IIs treatment should be recommended for the elderly patients of IFF with lateral wall fractures, because of its shorter operation time, faster full weight bearing, faster function recovery, and lower failure rate. However, more attention should be payed to its larger blood loss.
比较动力髋锁定钢板（DHLP）和股骨近端抗旋髓内钉-Ⅱ型（PFNA-Ⅱ）治疗老年股骨转子间骨折（IFF）合并外侧壁骨折的临床效果，为临床实践提供依据。
回顾性分析2009年12月至2015年4月间43例IFF合并外侧壁骨折患者的资料。比较两组患者的术中变量、术后并发症及功能情况。
17例患者采用DHLP治疗，26例采用PFNA-Ⅱ治疗。患者随访6至16个月，平均11个月。两组术前人口统计学数据具有可比性。与DHLP组相比，PFNA-Ⅱ组手术时间、完全负重时间及骨折愈合时间更短，但术中出血量更多（P<0.05）。此外，DHLP组内固定失败率显著高于PFNA-Ⅱ组。术后第三个月，PFNA-Ⅱ组的平均髋关节Harris评分（HHS）及优良率均显著高于DHLP组（P<0.05）。
对于老年IFF合并外侧壁骨折患者，推荐使用PFNA-Ⅱ治疗，因其手术时间短、完全负重快、功能恢复快且失败率低。然而，应更多关注其术中出血量较多的问题。
