Jin Li-Kun, Li Ye, Zhang Jie, Dong Yan-Xu, Qi Yue-Feng
Beijing Fengsheng Traditional Chinese Medicine Orthopaedic Hospital, Beijing 100033, China.
Zhongguo Gu Shang. 2024 Mar 25;37(3):293-9. doi: 10.12200/j.issn.1003-0034.20230275.
To explore clinical efficacy of proximal femoral nail anti-rotation(PFNA),InterTan and proximal femoral bionic intramedullary nail (PFBN) in treating femoral intertrochanteric fracture.
Clinical data of 120 patients with intertrochanteric fracture who were underwent closed reduction intramedullary nail-internal fixation from January 2020 to January 2021 were retrospectively analyzed. According to methods of internal fixation,patients were divided into 3 groups. There were 25 patients in PFBN group,including 16 females and 9 males,aged from 69 to 79 years old with an average of (73.67±5.16) years old. There were 55 patients in PFNA group,including 38 females and 17 males,aged from 68 to 80 years old with an average of (74.23±5.57) years old. There were 40 patients in InterTan group,including 26 females and 14 males,aged from 68 to 79 years old with an average of (73.45±5.34) years old. Operative time,intraoperative blood loss,incision length,hospital stay,weight-bearing time,fracture healing time and complications among 3 groups were compared,and clinical effect was evaluated by Harris score of hip function before operation,1,6 and 12 months after opertaion,respectively.
Patients among 3 groups were successfully completed operation and were followed up for more than 12 months. There were no significant difference in hospital stay,operative time,intraoperative blood loss and incision length among 3 groups (>0.05). Weight bearing time of PFBN group (7.98±1.34) d and InterTan group (8.22±0.46) d were earlier than that of PFNA group (10.27±0.66) d(<0.01). Fracture healing time of PFBN group (10.14±2.33) weeks and InterTan group (11.87±2.48) weeks were earlier than that of PFNA group (13.68±2.36) weeks (<0.01). One month after operation,Harris score in PFBN group (70.52±5.34) and InterTan group (69.81±6.17) was higher than that of PFNA group (51.46±5.36),and there was no significant difference between PFBN group and InterTan group (>0.05). There were no significant difference in Harris scores among 3 groups before operation,6 and 12 months after opertaion(>0.05). Cases of complication of InterTan group and PFNA group were lower than that of PFNA group (<0.05).
PFBN and InterTan for the treatment of intertrochanteric fracture have advantages of faster fracture healing,earlier weight-bearing time and fewer postoperative complications than traditional PFNA,but three operations could achieve higher effective rates without significant difference in long-term results.
探讨股骨近端防旋髓内钉（PFNA）、InterTan及股骨近端仿生髓内钉（PFBN）治疗股骨转子间骨折的临床疗效。
回顾性分析2020年1月至2021年1月行闭合复位髓内钉内固定治疗的120例转子间骨折患者的临床资料。根据内固定方法将患者分为3组。PFBN组25例，其中女性16例，男性9例，年龄69～79岁，平均（73.67±5.16）岁。PFNA组55例，其中女性38例，男性17例，年龄68～80岁，平均（74.23±5.57）岁。InterTan组40例，其中女性26例，男性14例，年龄68～79岁，平均（73.45±5.34）岁。比较3组患者的手术时间、术中出血量、切口长度、住院时间、负重时间、骨折愈合时间及并发症情况，并分别于术前、术后1、6、12个月采用髋关节功能Harris评分评估临床疗效。
3组患者均顺利完成手术，随访时间均超过12个月。3组患者的住院时间、手术时间、术中出血量及切口长度比较，差异均无统计学意义（>0.05）。PFBN组负重时间（7.98±1.34）d和InterTan组（8.22±0.46）d早于PFNA组（10.27±0.66）d（<0.01）。PFBN组骨折愈合时间（10.14±2.33）周和InterTan组（11.87±2.48）周早于PFNA组（13.68±2.36）周（<0.01）。术后1个月，PFBN组Harris评分（70.52±5.34）和InterTan组（69.81±6.17）高于PFNA组（51.46±5.36），PFBN组与InterTan组比较，差异无统计学意义（>0.05）。术前、术后6、12个月3组患者Harris评分比较，差异均无统计学意义（>0.05）。InterTan组和PFNA组并发症例数低于PFNA组（<0.05）。
与传统PFNA相比，PFBN和InterTan治疗转子间骨折具有骨折愈合快、负重时间早、术后并发症少等优点，但三种手术均能达到较高有效率，远期结果差异无统计学意义。
