Sharma Anmol, Sethi Anisha, Sharma Shardaindu
Government Multispecialty Hospital, Chandigarh, India.
Government Medical College and Hospital, Chandigarh, India.
Rev Bras Ortop. 2017 Nov 8;53(4):477-481. doi: 10.1016/j.rboe.2017.07.008. eCollection 2018 Jul-Aug.
To evaluate and compare the clinical and radiological outcomes of patients with stable intertrochanteric fractures treated with proximal femoral nail vs. dynamic hip screw.
Sixty patients with stable intertrochanteric fractures, aged over 18 years, were randomly divided into the proximal femoral nail and dynamic hip screw groups. Dynamic hip screw with a three-hole side-plate and an anti-rotation screw were used, as well as a modified ultra-short proximal femoral nail for the smaller Asian population. The intra-operative, early and late complications were recorded, and the functional outcome of each group was assessed using the Harris Hip Score.
In the dynamic hip screw group, the one-month mean Harris Hip Score was slightly lower than that of the proximal femoral nail group. However, at the three- and six-month monthly follow-ups, the dynamic hip screw group presented higher mean scores than the proximal femoral nail group; at the one-year follow-up, both the groups attained similar scores.
Proximal femoral nail provides a significantly shorter surgery with a smaller incision that leads to less wound-related complications. However, the incidence of technical errors was significantly higher in proximal femoral nail when compared with dynamic hip screw as it is a technically more demanding surgery that leads to more implant failures and the consequent re-operations.
评估并比较采用股骨近端髓内钉与动力髋螺钉治疗稳定型股骨转子间骨折患者的临床和影像学结果。
60例年龄超过18岁的稳定型股骨转子间骨折患者被随机分为股骨近端髓内钉组和动力髋螺钉组。使用带有三孔侧板和防旋螺钉的动力髋螺钉，以及针对体型较小的亚洲人群改良的超短型股骨近端髓内钉。记录术中、早期和晚期并发症，并使用Harris髋关节评分评估每组的功能结果。
在动力髋螺钉组中，1个月时的平均Harris髋关节评分略低于股骨近端髓内钉组。然而，在3个月和6个月的随访中，动力髋螺钉组的平均评分高于股骨近端髓内钉组；在1年随访时，两组评分相似。
股骨近端髓内钉手术时间明显更短，切口更小，导致与伤口相关的并发症更少。然而，与动力髋螺钉相比，股骨近端髓内钉技术失误的发生率明显更高，因为它是一项技术要求更高的手术，会导致更多的植入物失败以及随后的再次手术。
