Department of Orthopaedic, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Orthopaedic, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
Orthop Surg. 2020 Apr;12(2):543-551. doi: 10.1111/os.12656.
To assess long-term follow-up evaluations for the treatment of femoral intertrochanteric fractures with the "three-finger method" assisted by proximal femoral nail antirotation (PFNA).
From January 2010 to January 2017, 123 patients were selected and followed for the treatment of femoral intertrochanteric fractures with PFNA assisted by the "three-finger method" (application of the index finger, middle finger, and ring finger in the process of surgery to assist PFNA). There were 56 male patients and 67 female patients aged 52-93 years with an average age of 75.6 years, and 88 cases were due to a fall and 35 due to a traffic accident injury. The femoral necks were fixed with PFNA assisted by the "three-finger method" applying the following procedure: traction reduction, determining the incision, inserting the needle, and placing screw. The Harris hip score, postoperative complications, hip pain and function status were statistically analyzed to evaluate the surgical efficacy and to discuss the surgical technique of the "three-finger method" assisted by PFNA.
According to the Harris scoring criteria, patients were followed for 1, 2, 4, 6, and 8 years, and the good outcomes of patients were recorded. The excellent and good rate of 87% was the highest in the second year of follow-up. Then, the rate decreased following the eighth year of follow-up. The excellent and good rate of 82.7% was the lowest. The patients with incisions healed well, there were no instances of fat liquefaction or infection. There were three cases of effusion, the rate was 2.4%. The secretions were cultured, and no bacterial growth was found. After treatment of the wound, it healed, and the spiral blade used for the femoral head did not wear out. There was one case of femoral head necrosis. There was no significant correlation between hip pain and sex and age (P > 0.05), and the function of the hip joint was significantly correlated with the age of the patients (P < 0.05).
The "three-finger method" in the process of surgery to assist PFNA for the treatment of patients with intertrochanteric fractures of the femur simplified the operation steps, reduced the operation difficulty, shortened the operation time, improved the operation efficiency, and reduced the incidence of postoperative complications.
评估股骨粗隆间骨折采用股骨近端防旋髓内钉（PFNA）辅助“三指法”治疗的长期随访结果。
2010 年 1 月至 2017 年 1 月，选择并随访了 123 例采用 PFNA 辅助“三指法”（手术过程中应用食指、中指和环指辅助 PFNA）治疗股骨粗隆间骨折的患者。其中男 56 例，女 67 例；年龄 52-93 岁，平均 75.6 岁；88 例为摔伤，35 例为交通伤。股骨颈采用 PFNA 辅助“三指法”固定，具体操作包括牵引复位、确定切口、置针和置钉。采用 Harris 髋关节评分对髋关节疼痛和功能状况进行统计分析，评估手术疗效，并探讨 PFNA 辅助“三指法”的手术技术。
根据 Harris 评分标准，患者随访 1、2、4、6 和 8 年，记录患者的良好结局。随访第 2 年时，患者的优良率最高，为 87%。然后，随着随访时间的延长，优良率逐渐下降，随访第 8 年时优良率最低，为 82.7%。所有患者切口愈合良好，无脂肪液化或感染。有 3 例关节腔积液，发生率为 2.4%。分泌物培养未见细菌生长。经伤口治疗后，积液吸收，股骨头所用螺旋刀片未磨损。有 1 例股骨头坏死。髋关节疼痛与性别和年龄无显著相关性（P > 0.05），而髋关节功能与患者年龄显著相关（P < 0.05）。
PFNA 辅助“三指法”治疗股骨粗隆间骨折简化了手术步骤，降低了手术难度，缩短了手术时间，提高了手术效率，降低了术后并发症发生率。
