Varmış Hasan Orkun, Gökmen Mehmet Yiğit, Tan İsmet
Department of Orthopedics and Traumatology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye.
Çukurova University Faculty of Medicine, Department of Orthopedics and Traumatology, Adana, Türkiye.
PLoS One. 2025 Jan 6;20(1):e0316954. doi: 10.1371/journal.pone.0316954. eCollection 2025.
This study aimed to analyze the files of patients treated using PFN-A or INTERTAN intramedullary nails to reveal additional superiorities or disadvantageous factors for selecting the better intramedullary fixation method in patients presenting with intertrochanteric femur fractures.
In this retrospective study, the files of the patients who were operated on for intertrochanteric femur fractures using intramedullary fixation methods between September 2010 and June 2015 in the Orthopedics and Traumatology Clinic, Çukurova University Faculty of Medicine, were reviewed. The data including age, gender, chronic diseases, causes of fractures, fracture classification based on Arbeitsgemeinschaft für Osteosynthesefragen (AO), the nail type (long or short), the interval between trauma and surgery, duration of anesthesia and surgery, hospitalization duration, amount of blood transfusion, the Tip-Apex Distance (TAD) in postoperative radiographs, functional outcomes according to Harris Hip Score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), postoperative complications, need for revision, and mortality was noted. The data of the follow-up visits included physical examination findings in addition to the radiological assessment findings obtained using X-ray imaging involving the evaluation of the union in terms of the presence of infection, loss of reduction, implant failure, avascular necrosis, additional signs related to poor union formation, and the position data of the lag screw placement point according to Cleveland and Bosworth Quadrants.
The records showed that 194 files were available for analysis. The mean age of the patients included in the study was 70.9±16.4 years; 100 patients (51.5%) were male, and 94 (48.5%) were female. There were 76 patients (39%) in the PFN-A group and 118 patients (61%) in the INTERTAN group. Analysis of the mean Harris Hip Scores in both nail groups showed that only the mean scores at the 1st follow-up were statistically significantly different (P = 0.025).
In conclusion, comparing the two nail types in terms of complication rates and clinical data, neither nail has proven superior to the other. Moreover, the temporary difference in the first follow-up HHS scores should not be considered an indicator of the overall functional outcome because long-term follow-up HHS scores did not differ.
本研究旨在分析使用PFN-A或INTERTAN髓内钉治疗的患者档案，以揭示在股骨转子间骨折患者中选择更好的髓内固定方法的其他优势或不利因素。
在这项回顾性研究中，回顾了2010年9月至2015年6月在库库洛瓦大学医学院骨科与创伤科使用髓内固定方法治疗股骨转子间骨折的患者档案。记录的数据包括年龄、性别、慢性病、骨折原因、基于AO（Arbeitsgemeinschaft für Osteosynthesefragen）的骨折分类、钉的类型（长或短）、创伤与手术之间的间隔、麻醉和手术持续时间、住院时间、输血量、术后X线片上的尖顶距（TAD）、根据Harris髋关节评分（HHS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）的功能结果、术后并发症、翻修需求和死亡率。随访的数据除了包括使用X线成像获得的放射学评估结果外，还包括体格检查结果，X线成像涉及根据感染、复位丢失、植入物失败、缺血性坏死、与愈合不良形成相关的其他体征以及根据克利夫兰和博斯沃思象限的拉力螺钉放置点的位置数据来评估愈合情况。
记录显示有194份档案可供分析。纳入研究的患者平均年龄为70.9±16.4岁；100例患者（51.5%）为男性，94例（48.5%）为女性。PFN-A组有76例患者（39%），INTERTAN组有118例患者（61%）。对两组髓内钉的平均Harris髋关节评分分析表明，仅第1次随访时的平均评分有统计学显著差异（P = 0.025）。
总之，就并发症发生率和临床数据而言，比较这两种髓内钉，没有一种髓内钉被证明优于另一种。此外，第1次随访HHS评分的暂时差异不应被视为总体功能结果的指标，因为长期随访的HHS评分并无差异。
