Solunke Swaroop, Nair Abhishek, Agrawal Rahul, Deshmukh Ashwin, Barosani Ankit
Orthopaedics, Dr D Y Patil Medical College Hospital and Research Center, Dr D Y Patil Vidyapeeth (Deemed to be University) Pimpri, Pune, IND.
Cureus. 2024 Aug 25;16(8):e67774. doi: 10.7759/cureus.67774. eCollection 2024 Aug.
Aim Evaluation and comparison of various methods of trochanteric fracture fixation. Methods This study was conducted prospectively at the Orthopaedics Department of Dr. D Y Patil Medical College and Research Centre. The study spanned 18 months and involved 100 patients treated in the outpatient and the emergency department. Patients who fulfilled that specific criteria were selected for this study and the appropriate surgical intervention for each group was determined through radiological examination. Results Of the 100 patients, 55 (55%) were male and 45 (45%) females. Patients in our collection ranged from 20 to 90 years old. Proximal Femoral Nail (PFN), Dynamic Hip Screw (DHS ), and Proximal Femoral Locking Compression Plate (PFLCP ) groups averaged 56, 58, and 64 years old, respectively. The most common cause of intertrochanteric fracture was domestic falls (60%), followed by road traffic accidents (35%). The Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification rated 40 individuals (40%) as stable and 60 as unstable. Most patients in our study had unstable A3 fractures. PFN patients had 16 A3 fractures. In DHS, 32 patients suffered A3 fractures. Twelve PFLCP patients suffered A3 fractures. The smallest group had A1 fractures. Six PFN patients suffered A1 fractures. Two DHS patients had A1 fractures. Two PFLCP patients suffered A1 fractures. PFN group mean scores improved significantly after one and three months in this study. At six months, the PFN group had a significant mean score improvement. Conclusion PFN results ranged from satisfactory to excellent, offering numerous advantages over other methods such as DHS and PFLCP. The benefits of PFN include a shorter lever arm, fracture site compression, and enhanced rotational stability, which contribute to a lower chance of mechanical failure. Additionally, patients treated with PFN typically experience shorter hospital stays, earlier mobilization, less blood loss, shorter surgery times, faster rehabilitation, and quicker bone healing, making PFN a highly effective treatment option for certain fractures.
目的 评估和比较股骨转子间骨折的各种固定方法。方法 本研究在DY帕蒂尔医学院及研究中心骨科进行前瞻性研究。该研究历时18个月，纳入了100例在门诊和急诊科接受治疗的患者。符合特定标准的患者被选入本研究，并通过影像学检查确定每组的适当手术干预措施。结果 100例患者中，55例（55%）为男性，45例（45%）为女性。我们收集的患者年龄在20至90岁之间。股骨近端髓内钉（PFN）组、动力髋螺钉（DHS）组和股骨近端锁定加压钢板（PFLCP）组的平均年龄分别为56岁、58岁和64岁。转子间骨折最常见的原因是家庭跌倒（60%），其次是道路交通事故（35%）。根据AO（Arbeitsgemeinschaft für Osteosynthesefragen）分类，40例患者（40%）为稳定型，60例为不稳定型。我们研究中的大多数患者为不稳定的A3型骨折。PFN组有16例A3型骨折。在DHS组，32例患者发生A3型骨折。12例PFLCP组患者发生A3型骨折。最小的组为A1型骨折。6例PFN组患者发生A1型骨折。2例DHS组患者发生A1型骨折。2例PFLCP组患者发生A1型骨折。在本研究中，PFN组在1个月和3个月后的平均评分有显著改善。在6个月时，PFN组的平均评分有显著提高。结论 PFN的结果从满意到优秀不等，与DHS和PFLCP等其他方法相比有许多优势。PFN的优点包括杠杆臂较短、骨折部位加压以及旋转稳定性增强，这有助于降低机械性失败的几率。此外，接受PFN治疗的患者通常住院时间较短、更早活动、失血更少、手术时间更短、康复更快、骨折愈合更快，使PFN成为某些骨折的高效治疗选择。
