B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Birat Medical College and Teaching Hospital, Biratnagar, Nepal.
J Nepal Health Res Counc. 2020 Sep 8;18(2):301-306. doi: 10.33314/jnhrc.v18i2.2956.
Intramedullary fixation is biomechanically superior to extramedullary fixation for fracture of peritrochanteric region of femur in elderly which is often complicated due to associated osteoporosis. Helical blade of proximal femoral nail antirotation II has stronger purchase in the head of femur preventing rotation and cutout. This study was done to evaluate the outcome of Proximal Femoral Nail Antirotation II fixation in B.P. Koirala Institute of Health Sciences.
Retrospective review of the data of 100 traumatic peritrochanteric fracture cases operated between March 2017 and March 2018 was done for study. Cases lost to follow-up, deaths and incomplete functional outcome (VAS, HHS), intraoperative and postoperative data were excluded. Total of 71 cases were included in the study.
Mean age of patients was 65 (+14) (range:19 to 86) years and were operated for intertrochanteric (54), subtrochanteric (16) and neck of femur (1) fractures. Trivial fall on ground was the commonest mechanism of injury (43 of 71). Mean injury to surgery time was 7 (+7) days and mean duration of hospital stay was 5.92 (+4) days. Mean blood loss during surgery was 132.61 (+21) ml and mean surgical time was 56 (+8) minutes. Mean visual analogue scale (VAS) Score was 7 at 2 weeks, 3 at 6 weeks and 1 at 12 weeks. Mean harris hip score was 80 (+10) at 6 months.
Proximal femoral nail antirotation II is a reliable implant system to use for fixation of proximal femoral fractures with a good functional outcome and low complication rates.
在老年股骨转子间区骨折中，髓内固定在生物力学上优于髓外固定，因为常伴有骨质疏松症等并发症。股骨近端防旋钉Ⅱ的螺旋刀片在股骨头上具有更强的把持力，可防止旋转和脱出。本研究旨在评估在博卡拉医科大学健康科学研究所使用股骨近端防旋钉Ⅱ固定治疗股骨转子间骨折的效果。
对 2017 年 3 月至 2018 年 3 月期间收治的 100 例创伤性股骨转子间骨折患者的资料进行回顾性研究。排除失访病例、死亡病例以及功能结局（VAS、HHS）不完整、术中及术后资料不全的病例。共纳入 71 例病例进行研究。
患者的平均年龄为 65（+14）岁（范围：19-86 岁），其中股骨转子间骨折 54 例，转子下骨折 16 例，股骨颈骨折 1 例。最常见的损伤机制是轻微的平地摔倒（71 例中有 43 例）。受伤至手术时间的平均时间为 7（+7）天，平均住院时间为 5.92（+4）天。手术过程中的平均失血量为 132.61（+21）ml，平均手术时间为 56（+8）分钟。术后 2 周的平均视觉模拟评分（VAS）为 7 分，6 周为 3 分，12 周为 1 分。术后 6 个月的平均 Harris 髋关节评分为 80（+10）分。
股骨近端防旋钉Ⅱ是一种可靠的内固定系统，用于治疗股骨近端骨折，具有良好的功能结果和较低的并发症发生率。
