Bo Yu, Qin Yue, Zang Yuan, Yang Haibo
Department of Trauma Orthopedics.
Department of Clinical Skills Training Center, General Hospital of Ningxia Medical University, Ningxia, China.
Medicine (Baltimore). 2020 Oct 30;99(44):e23046. doi: 10.1097/MD.0000000000023046.
Normally taking the surgery is the standard treatment, between sliding hip screw (SHS) and utilizing proximal femoral nail antirotation (PFNA) for intramedullary fixation, it is still not certain which one work better for this type of fracture. Our purpose for this study was to determine the optimum choice of implant for a patient with an unstable intertrochanteric fracture.
In our hospital, a reflective analysis was conducted of all unstable intertrochanteric fractures treated with either a SHS or PFNA fixation between February 2015 and February 2018. The rules of choosing patients were the following: older age of more than 60, unstable intertrochanteric fractures, and willingness to take clinical and radiographic follow-up researches for over 12 months. In this case, patients bearing former hip surgery at any side were removed from the candidates. Demographic characteristics collected effective information including gender, date of operation, and other relevant information. Postoperative outcome measures included operation time, total blood loss amount, validated mobility score, surgery-related syndrome, and tip-apex length. The patients were re-examined at three time periods: 3 weeks, 3 months, and 1 year. The result of P < .05 was considered to be statistically significant.
We were able to directly compare the outcomes of PFNA vs SHS techniques and might reveal a better technique in treatment of an unstable intertrochanteric fracture.
This study protocol has been registered in Research Registry (researchregistry6057).
通常手术是标准治疗方法，在滑动髋螺钉（SHS）和使用股骨近端抗旋髓内钉（PFNA）进行髓内固定之间，对于这类骨折哪种方法效果更好仍不确定。本研究的目的是确定不稳定型转子间骨折患者植入物的最佳选择。
在我院，对2015年2月至2018年2月期间采用SHS或PFNA固定治疗的所有不稳定型转子间骨折进行回顾性分析。选择患者的标准如下：年龄超过60岁，不稳定型转子间骨折，且愿意接受超过12个月的临床和影像学随访研究。在这种情况下，任何一侧曾接受过髋关节手术的患者被排除在候选者之外。人口统计学特征收集有效信息包括性别、手术日期和其他相关信息。术后结果指标包括手术时间、总失血量、有效活动评分、手术相关综合征和尖顶长度。患者在三个时间段进行复查：3周、3个月和1年。P<0.05的结果被认为具有统计学意义。
我们能够直接比较PFNA与SHS技术的结果，并可能揭示治疗不稳定型转子间骨折的更好技术。
本研究方案已在研究注册库（researchregistry6057）注册。
