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股骨近端仿生钉(PFBN)——一种治疗不稳定型股骨转子间骨折的创新手术方法。

Proximal femoral bionic nail (PFBN)-an innovative surgical method for unstable femoral intertrochanteric fractures.

作者信息

Zhao Haiyue, Deng Xiangtian, Liu Weijian, Chen Wei, Wang Lei, Zhang Yiran, Wang Zhongzheng, Wang Yuchuan, Lian Xiaodong, Hou Zhiyong, Zhang Qi, Zhang Yingze

机构信息

School of Medicine, Nankai University, Tianjin, 300071, China.

Trauma Medical Center, Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.

出版信息

Int Orthop. 2023 Apr;47(4):1089-1099. doi: 10.1007/s00264-023-05696-y. Epub 2023 Jan 31.

Abstract

PURPOSE

Intertrochanteric femoral fractures (IFF) are one of the most common traumatic conditions, but there are no established treatment methods for this condition due to implant failure and re-operation rates. The proximal femoral bionic nail (PFBN), which is a new design of the cephalomedullary nail, was developed by our team. The objective of this study was to assess the clinical and radiographic outcomes of PFBN in patients with unstable IFF.

METHODS

From October 2020 to August 2021, 12 patients diagnosed with unstable IFF (31-A2, 3) were treated with PFBN at the Third Hospital of Hebei Medical University. We evaluated the clinical therapeutic effects of this treatment by measuring peri-operative indicators and post-operative complications. Clinical outcomes, specific radiographic parameters, and post-operative complications were collected and analyzed within the first post-operative year.

RESULTS

The average age of the patients was 72.4 ± 16.1 years (five males and seven females). The mean operation time was 90.4 ± 16.0 min, whereas the operation time of 31-A2 fractures (83.1 ± 12.2 min) was shorter than that of 31-A3 fractures (105.0 ± 12.9 min) (p < 0.05). The blood loss was 175 ml (range: 50 to 500 ml), and the length of hospitalization was 10.0 ± 1.9 days. The prognosis evaluation was assessed at three, six and 12 months after the operation; for these time points, the Harris hip scores were 69.6 ± 4.1, 77.8 ± 3.8, and 82.6 ± 4.6, respectively, and the Parker-Palmer scores were 5.3 (5.0, 7.0), 6.3 (5.3, 7.0), and 7.8 (7.0, 8.0), respectively.

CONCLUSION

PFBN has shown advantages in the treatment of unstable IFF (particularly in geriatric patients) and possesses both stability and safety. This innovative method may provide a new option for treating unstable IFFs.

摘要

目的

股骨粗隆间骨折(IFF)是最常见的创伤性疾病之一,但由于植入物失败和再次手术率,目前尚无成熟的治疗方法。股骨近端仿生钉(PFBN)是我们团队研发的一种新型髓内钉设计。本研究的目的是评估PFBN治疗不稳定IFF患者的临床和影像学结果。

方法

2020年10月至2021年8月,河北医科大学第三医院对12例诊断为不稳定IFF(31 - A2,3型)的患者采用PFBN治疗。我们通过测量围手术期指标和术后并发症来评估该治疗的临床疗效。在术后第一年内收集并分析临床结果、特定的影像学参数和术后并发症。

结果

患者的平均年龄为72.4±16.1岁(男性5例,女性7例)。平均手术时间为90.4±16.0分钟,而31 - A2型骨折的手术时间(83.1±12.2分钟)短于31 - A3型骨折(105.0±12.9分钟)(p<0.05)。出血量为175毫升(范围:50至500毫升),住院时间为10.0±1.9天。术后3个月、6个月和12个月进行预后评估;在这些时间点,Harris髋关节评分分别为69.6±4.1、77.8±3.8和82.6±4.6,Parker - Palmer评分分别为5.3(5.0,7.0)、6.3(5.3,7.0)和7.8(7.0,8.0)。

结论

PFBN在治疗不稳定IFF(尤其是老年患者)方面显示出优势,具有稳定性和安全性。这种创新方法可能为治疗不稳定IFF提供一种新的选择。

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