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InterTAN与PFNA内固定治疗老年股骨粗隆间骨折的比较:一项回顾性队列研究。

Comparison of InterTAN and PFNA internal fixation for elderly patients with intertrochanteric fracture: A retrospective cohort study.

作者信息

Li Li, Fang Xing, Gao Jie, Han Weizhen, Kong Xiangan

机构信息

Li Li, Department of Orthopedics, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, 246 Heping Road, Hefei City, Anhui Province 230011, P.R. China.

Xing Fang, Department of Orthopedics, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, 246 Heping Road, Hefei City, Anhui Province 230011, P.R. China.

出版信息

Pak J Med Sci. 2024 Mar-Apr;40(4):589-594. doi: 10.12669/pjms.40.4.8794.

Abstract

OBJECTIVE

To compare the clinical outcomes of InterTAN nail and proximal femoral nail antirotation (PFNA) internal fixation for the treatment of intertrochanteric fractures in the elderly.

METHODS

We retrospectively reviewed the clinical records of 151 elderly patients with intertrochanteric fractures treated in The Second People's Hospital of Hefei from October 2019 to December 2021. Among them, 73 patients had undergone InterTAN (InterTAN group) and 78 patients had undergone PFNA (PFNA group) internal fixation. Operation-related variables (operation time, incision length, intraoperative bleeding volume, hospital stays length, and fracture healing time), complications, and Harris scores were compared between the two groups.

RESULTS

The operation time and incision length were shorter and the intraoperative bleeding was less in the PFNA group than in the InterTAN group (all <0.05), but the fracture healing time was longer in the PFNA group (<0.05). We found similar hospital stays and surgical complications in the two groups (>0.05). In addition, the Harris hip joint scores were significantly higher in the InterTAN group than in the PFNA group at one, six, and twelve months after the operation (<0.05).

CONCLUSIONS

InterTAN and PFNA internal fixation have their own advantages in treating patients with intertrochanteric fractures. InterTAN has better postoperative recovery results, while PFNA has less perioperative trauma. Clinically, InterTAN or PFNA should be selected based on the specific conditions of each patient to maximize the therapeutic benefit of each treatment method.

摘要

目的

比较InterTAN钉与股骨近端防旋髓内钉(PFNA)内固定治疗老年股骨转子间骨折的临床疗效。

方法

回顾性分析2019年10月至2021年12月在合肥市第二人民医院接受治疗的151例老年股骨转子间骨折患者的临床资料。其中,73例患者接受InterTAN钉内固定(InterTAN组),78例患者接受PFNA内固定(PFNA组)。比较两组的手术相关变量(手术时间、切口长度、术中出血量、住院时间和骨折愈合时间)、并发症及Harris评分。

结果

PFNA组的手术时间和切口长度较InterTAN组短,术中出血量较InterTAN组少(均P<0.05),但PFNA组的骨折愈合时间较长(P<0.05)。两组的住院时间和手术并发症相似(P>0.05)。此外,术后1个月、6个月和12个月时,InterTAN组的Harris髋关节评分显著高于PFNA组(P<0.05)。

结论

InterTAN钉和PFNA内固定在治疗股骨转子间骨折患者方面各有优势。InterTAN钉术后恢复效果较好,而PFNA的围手术期创伤较小。临床上,应根据每位患者的具体情况选择InterTAN钉或PFNA,以最大限度地发挥每种治疗方法的治疗效益。

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