|
|
|
| Clinical effect of PFNA and InterTan internal fixation in the treatment of elderly intertrochanteric fracture |
| WANG Wei YANG Shen TAO Yong ZHANG Yifei▲ |
| Department of Traumatic Orthopedics, the First People′s Hospital of Hefei City, Anhui Province, Hefei 230061, China |
|
|
|
Abstract Objective To investigate the clinical effect of proximal femoral nail antirotation (PFNA) and InterTan internal fixation in the treatment of elderly intertrochanteric fracture and provide reference for clinical treatment. Methods The clinical data of 94 elderly patients with intertrochanteric fractures admitted to the First People′s Hospital of Hefei City, Anhui Province from January 2016 to April 2019 were retrospectively analyzed. The patients were divided into PFNA group and InterTan group by different intraoperative fixation methods, with 47 patients in each group. Perioperative conditions, Harris score and complications during follow-up were compared between the two groups. Results There were no statistically significant differences between the two groups in incision length, hospital stay, early load-bearing time and fracture healing time (P ＞ 0.05). The operation time of PFNA group was shorter than that of InterTan group, intraoperative blood loss was less than that of InterTan group and drainage volume 24 h after operation was more than that of InterTan group, and the differences were statistically significant (all P ＜ 0.05). Overall analysis: there were statistically significant differences between the two groups at different time points (P ＜ 0.05), while there were no statistically significant differences between the two groups in comparison and interaction (P ＞ 0.05). Further pairwise comparison showed that Harris scores were higher in both groups six and twelve months after surgery than before surgery, and that twelve months after surgery was higher than six months after surgery in both groups, with statistically significant differences (all P ＜ 0.05). During follow-up, the total incidence of complications in the PFNA group was higher than that in the InterTan group, and the difference was statistically significant (P ＜ 0.05). Conclusion The effects of PFNA and InterTan internal fixation in elderly patients with intertrochanteric fractures are similar. PFNA internal fixation can be used to reduce injuries in patients with poor systemic condition, while InterTan internal fixation can be used to reduce long-term complications in patients with good systemic condition.
|
|
|
|
|
|
[1] 翁蔚宗，李密，周启荣，等.髋部骨折流行病学分布特点：单中心2859例分析[J].第二军医大学学报，2017，38（4）：415-420.
[2] 陈宇翔，唐佩福.股骨粗隆间骨折内固定手术治疗的研究进展[J].解放军医学院学报，2017，38（2）：171-174， 178.
[3] 吴利军.3种内固定手术治疗老年股骨粗隆间骨折的临床对照研究[J].重庆医学，2017，46（12）：1681-1684.
[4] 马彦成，陈爱民，江曦，等.DHS与InterTan内固定治疗老年股骨粗隆间骨折的疗效比较[J].中国骨与关节损伤杂志，2017，32（3）：252-254.
[5] 李建涛，张里程，唐佩福.股骨粗隆间骨折治疗理念与内固定器械的发展概述[J].中国修复重建外科杂志，2019， 33（1）：1-7.
[6] 崔勇，王鹏，陈会超，等.股骨近端防旋髓内钉内固定治疗股骨粗隆间骨折的应用体会[J].中国矫形外科杂志，2017，25（10）：946-949.
[7] 谢超春，陈爱民.PFLP与InterTan内固定治疗股骨粗隆下骨折的疗效分析[J].中国骨与关节损伤杂志，2017，32（3）：255-258.
[8] 王波，吴鹏，王铁军，等.InterTAN髓内钉治疗不稳定型老年股骨粗隆间骨折[J].临床和实验医学杂志，2017，16（5）：485-488.
[9] 胥少汀，葛宝丰，徐印坎.实用骨科学[M].北京：人民军医出版社，2005：78-80.
[10] 秦宏敏，刘汉涛，余东洋.高龄股骨粗隆间骨折手术治疗生存率分析[J].中国矫形外科杂志，2017，25（2）：123-125.
[11] 雷飞跃，张雪平.内固定术与人工髋关节置换术治疗老年股骨粗隆间骨折的疗效对比[J].中国骨与关节损伤杂志，2016，31（4）：405-406.
[12] 陆庆文，韦力，韦宝堂，等.不同手术方法治疗老年股骨粗隆间骨折的疗效比较[J].中国骨与关节损伤杂志，2018，33（8）：837-839.
[13] 王炎，汪海滨，史法见，等.PFNA和DHS固定治疗股骨粗隆间骨折的比较[J].中国矫形外科杂志，2019，27（24）：2223-2227.
[14] 李坛珠，张保焜，莫小联，等.极高龄不稳定股骨粗隆间骨折的髓内和髓外固定疗效比较[J].中华老年骨科与康复电子杂志，2017，3（1）：17-21.
[15] 聂治军，常彦海，袁启令，等.三种手术方式治疗高龄不稳定性股骨粗隆间骨折的对比研究[J].中华关节外科杂志：电子版，2017，11（2）：128-134.
[16] 许庆利，范勇，王兴元，等.PFNA与人工股骨头置换术治疗老年不稳定型股骨粗隆间骨折的临床疗效分析[J].创伤外科杂志，2017，19（2）：106-110.
[17] 李明东，胡稷杰，黎早敏，等.不同手术方式治疗老年股骨粗隆间骨折的疗效比较[J].中国修复重建外科杂志，2017，31（6）：653-658.
[18] 刘军，郝申申，刘志斌，等.G形臂X线机辅助股骨粗隆间骨折PFNA置入的应用价值[J].中国医药导报，2018， 15（36）：67-70.
[19] 周胜虎，甄平，李旭升，等.生物型FHR与PFNA治疗高龄股骨粗隆间骨折疗效观察[J].中国矫形外科杂志，2017，25（6）：487-491.
[20] 刘永伟，冯晓波，谢卯，等.PFNA与InterTan钉治疗老年股骨转子间不稳定性骨折临床疗效的比较：一项前瞻性研究[J].第二军医大学学报，2017，38（4）：432-436.
[21] 程建岗，孟国林，袁志，等.InterTan与可膨胀性髓内钉治疗股骨粗隆间骨折的疗效分析[J].中国骨与关节杂志，2019，8（6）：476-479.
[22] 罗成辉，符江.DHS、PFNA、InterTan内固定治疗老年不稳定股骨粗隆间骨折的比较[J].中国骨与关节损伤杂志，2019，34（2）：138-141.
[23] 杨飞，武永刚，李东亮，等.老年股骨粗隆间骨折3种髓内钉治疗体会[J].中国骨与关节损伤杂志，2016，31（6）：641-643.
[24] 徐宏伟，杨成林，卢永伟，等.新材料InterTan治疗52例老年骨质疏松性股骨粗隆间骨折的疗效分析[J].中华全科医学，2016，14（3）：512-514.
[25] 许大峰，朱雅龙，顾利华.INTERTAN与PFNA内固定治疗股骨粗隆间骨折的疗效比较[J].中国医药科学，2017，7（22）：218-220. |
|
|
|
