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老年股骨转子间骨折患者中联合加压顺行股骨转子间髓内钉(InterTan)与股骨近端抗旋髓内钉II(PFNA-II)功能和影像学结果的比较

A comparison of functional and radiological outcome of combine compression antegrade intertrochanteric nail (InterTan) and proximal femoral nail anti-rotation II (PFNA-II) in elderly patients with intertrochanteric fractures.

作者信息

Zhu Zhonglian, Zhao Zhi, Wang Xuyi, Wang Zhaodong, Guan Jianzhong

机构信息

Zhonglian Zhu, Department of Orthopedics, The First Affiliated Hospital of Bengbu Medical College, Anhui Key Laboratory of Tissue Transformation, Bengbu Medical College, Bengbu 233000, Anhui Province, P.R. China.

Zhi Zhao, Department of Orthopedics, The First Affiliated Hospital of Bengbu Medical College, Anhui Key Laboratory of Tissue Transformation, Bengbu Medical College, Bengbu 233000, Anhui Province, P.R. China.

出版信息

Pak J Med Sci. 2023 Jan-Feb;39(1):96-100. doi: 10.12669/pjms.39.1.6946.

Abstract

OBJECTIVE

To compare the functional and radiological outcome of combine compression interlocking intramedullary nail (InterTan) and proximal femoral nail anti-rotation II (PFNA-II) in the treatment of elderly patients with intertrochanteric fractures.

METHODS

As a retrospective cohort study, records of 88 patients with intertrochanteric fractures treated in our hospital from January 1, 2019 to July 31, 2021 were retrospectively reviewed. According to treatment records, it included 45 patients treated with InterTan (Group-A) and 43 patients treated with PFNA-II (Group-B). The operation safety and functional rehabilitation of the two groups were compared and analyzed.

RESULTS

This study included 88 patients with intertrochanteric fractures (mean [SD] age, 68.72 [0.10] years at baseline), of whom 52 (59.09%) were males and 36 (40.91%) were females. Operation time and intraoperative blood loss in Group-B were less than Group-A, while fracture healing time was shorter in Group-A. The fracture separation distance was measured four weeks after the operation. The widening rate of the fracture line in Group-A was lower than Group-B (4.4% vs.18.6%; <0.05). The incidence of complications in Group-A was lower than Group-B (4.4% vs.18.6%; <0.05). At three, six and twelve months after the operation, the Harris hip score of the two groups was higher than at discharge (<0.05), with no significant difference between groups (>0.05).

CONCLUSIONS

We found no significant difference in the functional outcome in elderly patients with intertrochanteric fractures treated with InterTan and PFNA-II. Early fracture healing and reduced complication rate however has been noted with InterTan.

摘要

目的

比较组合式加压交锁髓内钉(InterTan)与股骨近端抗旋髓内钉II(PFNA-II)治疗老年股骨转子间骨折的功能和影像学结果。

方法

作为一项回顾性队列研究,回顾性分析了2019年1月1日至2021年7月31日在我院接受治疗的88例股骨转子间骨折患者的记录。根据治疗记录,其中45例患者接受InterTan治疗(A组),43例患者接受PFNA-II治疗(B组)。比较并分析两组的手术安全性和功能康复情况。

结果

本研究纳入88例股骨转子间骨折患者(基线时平均[标准差]年龄为68.72[0.10]岁),其中男性52例(59.09%),女性36例(40.91%)。B组的手术时间和术中出血量少于A组,而A组的骨折愈合时间较短。术后4周测量骨折分离距离。A组骨折线增宽率低于B组(4.4%对18.6%;<0.05)。A组并发症发生率低于B组(4.4%对18.6%;<0.05)。术后3个月、6个月和12个月时,两组的Harris髋关节评分均高于出院时(<0.05),两组间无显著差异(>0.05)。

结论

我们发现InterTan和PFNA-II治疗老年股骨转子间骨折的功能结果无显著差异。然而,InterTan可实现早期骨折愈合并降低并发症发生率。

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本文引用的文献

1
Treatment of Elderly Femoral Intertrochanteric Fracture by InterTan Intramedullary Nail and PFNA.
Evid Based Complement Alternat Med. 2022 Jul 31;2022:5020960. doi: 10.1155/2022/5020960. eCollection 2022.
8
Is Full-Length Intramedullary Nail Necessary for Atypical Subtrochanteric Femoral Fracture Associated with Bisphosphonate?
J Bone Metab. 2020 May;27(2):133-142. doi: 10.11005/jbm.2020.27.2.133. Epub 2020 May 31.

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