Department of Orthopaedic Surgery and Traumatology, King Edward Medical University, Lahore, Pakistan.
Department of Orthopaedic Surgery, King Edward Medical University, Lahore, Pakistan.
J Pak Med Assoc. 2020 May;70(5):815-819. doi: 10.5455/JPMA.295426.
To compare the dynamic hip screw with proximal femoral nail for the treatment of Arbeitsgemeinschaft für Osteosynthesefragen type A2 and A3 per trochanteric fractures of femur.
The randomised controlled single-blind study was conducted at the Mayo Hospital, Lahore, Pakistan, from September 2015 to September 2017, and comprised patients aged 40-75 years with Arbeitsgemeinschaft für Osteosynthesefragen type A2 and A3 per trochanteric fracture. The patients randomised into two equal groups. In Group A, patients were treated by closed reduction and internal fixation with dynamic hip screw, while those in Group B were treated by closed reduction and internal fixation by proximal femoral nail. Follow-up was done at 2nd, 6th and 12th weeks, and at 6th, 9th and 12th month post-operatively. Variables evaluated were frequency of union, surgical time, approximate amount of blood loss and complications. The functional assessment was done by using Harris hip score. SPSS 20 was used for data analysis.
Of the 68 patients, there were 34(50%) in each group. The mean age of patients in Group A was 60.88±12.49 years and in Group B it was 59.32±2.39 years. The mean surgery time in Group A was 58.71±7.84 minutes and in Group B 35.35±5.48 minutes (p<0.05). Mean blood loss was 273.82±30.0ml and 149.79±21.3ml in Group A and B respectively (p<0.05). The mean Harris hip score after 12 months in Groups A and B were 81.83±23.01 and 87.62±17.28 respectively. Infection was seen in 2(5.9%) patients in Group A and 1(2.9%) in Group B.
Proximal femoral nail provided equivalent functional outcome compared to dynamic hip screw with lesser blood loss and surgical time.
比较动力髋螺钉与股骨近端髓内钉治疗 Arbeitsgemeinschaft für Osteosynthesefragen 型 A2 和 A3 股骨转子间骨折的效果。
这是一项在巴基斯坦拉合尔的 Mayo 医院进行的随机对照单盲研究，于 2015 年 9 月至 2017 年 9 月开展，纳入年龄在 40-75 岁的 Arbeitsgemeinschaft für Osteosynthesefragen 型 A2 和 A3 股骨转子间骨折患者。将患者随机均分为两组，A 组采用动力髋螺钉闭合复位内固定治疗，B 组采用股骨近端髓内钉闭合复位内固定治疗。术后第 2、6、12 周和术后第 6、9、12 个月进行随访。评估的变量包括愈合频率、手术时间、失血量和并发症。采用 Harris 髋关节评分进行功能评估。采用 SPSS 20 进行数据分析。
68 例患者中，每组各 34 例（50%）。A 组患者的平均年龄为 60.88±12.49 岁，B 组为 59.32±2.39 岁。A 组的平均手术时间为 58.71±7.84 分钟，B 组为 35.35±5.48 分钟（p<0.05）。A 组和 B 组的平均失血量分别为 273.82±30.0ml 和 149.79±21.3ml（p<0.05）。A 组和 B 组在术后 12 个月的平均 Harris 髋关节评分为 81.83±23.01 和 87.62±17.28。A 组有 2（5.9%）例患者发生感染，B 组有 1（2.9%）例患者发生感染。
与动力髋螺钉相比，股骨近端髓内钉具有相同的功能效果，且失血量和手术时间更少。
