Date Akshay, Panthula Mrinalini, Bolina Anita
Basildon and Thurrock University Hospital, Nethermayne, Basildon, Essex, SS16 5NL, UK.
Imperial College London, Exhibition Road, South Kensington, London SW7 2BU, UK.
Future Sci OA. 2020 Dec 7;7(1):FSO668. doi: 10.2144/fsoa-2020-0182.
Intertrochanteric fractures, accountable for 50% of hip fractures, can be fixed with cephalomedullary devices such as Proximal Femoral Nail Antirotation (PFNA™), Gamma3 nailing system and TRIGEN™ InterTAN™ nail (IT). IT uniquely uses two cephalocervical screws that allow for linear compression and provide additional resistance to femoral head rotation. A literature review assessing clinical outcomes of these devices was conducted, with 14 studies enrolling 3104 patients meeting the inclusion criteria. PFNA and Gamma3 had better intraoperative outcomes compared with IT; however, IT had superior implant-related outcomes of cut-out and screw migration. No difference was found between IT and PFNA or Gamma3 in Harris Hip Scores, time to union, malunion and nonunion. Further long-term studies are needed to evaluate clinical outcomes and cost-effectiveness of cephalomedullary devices.
转子间骨折占髋部骨折的50%，可用头髓内装置进行固定，如股骨近端抗旋髓内钉（PFNA™）、Gamma3钉系统和TRIGEN™ InterTAN™钉（IT）。IT独特地使用了两枚头颈螺钉，可实现线性加压，并为股骨头旋转提供额外阻力。我们进行了一项文献综述，评估这些装置的临床疗效，有14项研究纳入了3104例符合纳入标准的患者。与IT相比，PFNA和Gamma3的术中疗效更好；然而，IT在植入物相关的穿出和螺钉移位方面具有更好的疗效。在Harris髋关节评分、愈合时间、畸形愈合和不愈合方面，IT与PFNA或Gamma3之间未发现差异。需要进一步的长期研究来评估头髓内装置的临床疗效和成本效益。
