Department of Orthopaedics, Panzhihua Municipal Central Hospital, Province Sichuan, China.
Medicine (Baltimore). 2022 Jul 15;101(28):e29384. doi: 10.1097/MD.0000000000029384.
This study aimed to compare the clinical and radiographic outcomes of the proximal femoral nail antirotation (PFNA) and external fixation in the management of unstable intertrochanteric fractures in elderly patients.
Eighty-seven of 114 patients with unstable intertrochanteric fractures were included in this study between January 2015 and June 2019, 46 were fixed with PFNA implant and 41 with external fixator. Patient baseline characteristics, functional and radiographic results, and postoperative complication were documented and compared between the 2 groups.
Prolonged operation duration, increased fluoroscopy time, and excess blood loss occurred in PFNA group. The functional results scores seemed higher in the PFNA than external fixation group in the first semester, and thereafter, there was no significant difference between groups. On early postoperative radiographs, better femur neck-shaft angle was acquired in the external fixators device, but the difference did not continue at final visit. The incidence rate of overall complications was 43.5% for the group PFNA and 100% for the group external fixation.
Fewer postoperative complications occurred in PFNA than external fixator group when unstable intertrochanteric fractures were treated. Nevertheless, there was no significant difference detected in final functional and radiographic outcome between the 2 groups.
本研究旨在比较股骨近端防旋髓内钉（PFNA）和外固定器治疗老年不稳定型股骨转子间骨折的临床和影像学结果。
2015 年 1 月至 2019 年 6 月，共纳入 114 例不稳定型股骨转子间骨折患者，其中 46 例行 PFNA 内固定，41 例行外固定器固定。记录并比较两组患者的基线特征、功能和影像学结果及术后并发症。
PFNA 组手术时间延长、透视时间增加、出血量增加。PFNA 组在第一个半年的功能评分结果似乎高于外固定组，此后两组之间无显著差异。在早期术后 X 线片上，外固定器装置获得了更好的股骨颈干角，但在最终随访时差异并不持续。PFNA 组的总并发症发生率为 43.5%，而外固定组为 100%。
在治疗不稳定型股骨转子间骨折时，PFNA 组的术后并发症发生率低于外固定器组。然而，两组在最终的功能和影像学结果方面没有发现显著差异。
