Department of Orthopedics, Liaocheng People's Hospital, Liaocheng Clinical School of Taishan Medical University, Liaocheng, China.
Eur Rev Med Pharmacol Sci. 2018 Jul;22(1 Suppl):8-14. doi: 10.26355/eurrev_201807_15378.
We aim to compare the effects of stem type prosthesis implantation of the greater trochanter of the femur (GTF) and proximal femur nail anti-rotation (PFNA) for treatment of unstable intertrochanteric femoral fracture.
We retrospectively analyzed 108 patients with unstable intertrochanteric femoral fracture, including 61 cases who underwent GTF treatment and 47 cases who underwent PFNA treatment. We compared the operative time, blood loss, clinical healing and bone healing time, partial weight bearing and full weight bearing time, Harris hip score, rate of complications and rate of adverse reactions of implantation materials.
Comparing the two groups in terms of operative time and blood loss, the differences were not statistically significant (p>0.05). The clinical and bone healing time in the GTF group were shorter than those in the PFNA group and the differences were statistically significant (p<0.05). The partial and full-weight bearing times in the GTF group were significantly shorter than those in the PFNA group. The Harris scores, one and six months after surgery, were higher than those in the PFNA group and by comparing the scores after 12 and 18 months, the differences were not statistically significant (p>0.05). The rate of complications and rate of adverse reactions of implantation material in the GTF group were lower than those in the PFNA group and the differences were statistically significant (p<0.05).
GTF implantation is more advantageous in functional improvement and in reducing complications compared with PFNA for the treatment of unstable intertrochanteric femoral fracture.
比较股骨大转子（GTF）和股骨近端防旋髓内钉（PFNA）植入治疗不稳定型股骨转子间骨折的效果。
回顾性分析了 108 例不稳定型股骨转子间骨折患者，其中 61 例行 GTF 治疗，47 例行 PFNA 治疗。比较两组手术时间、出血量、临床愈合和骨愈合时间、部分负重和完全负重时间、Harris 髋关节评分、并发症发生率和植入物不良反应发生率。
两组手术时间和出血量比较，差异无统计学意义（p＞0.05）。GTF 组临床愈合和骨愈合时间短于 PFNA 组，差异有统计学意义（p＜0.05）。GTF 组部分和完全负重时间明显短于 PFNA 组。术后 1、6 个月 Harris 评分高于 PFNA 组，比较术后 12、18 个月评分，差异无统计学意义（p＞0.05）。GTF 组并发症发生率和植入物不良反应发生率低于 PFNA 组，差异有统计学意义（p＜0.05）。
与 PFNA 相比，GTF 植入在改善功能和减少并发症方面更具优势，可用于治疗不稳定型股骨转子间骨折。
