The clinical efficacy evaluation of Asian proximal femoral nail antirotation in treatment of intertrochanteric fractures in the elderly
10.3760/cma.j.issn.0254-9026.2013.07.022
- VernacularTitle:亚洲型股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的临床疗效
- Author:
Minghui LI
;
Hao PENG
;
Yang LIU
- Publication Type:Journal Article
- Keywords:
Hip fractures;
Fracture fixation,intramedullary;
Bone nails
- From:
Chinese Journal of Geriatrics
2013;32(7):757-760
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of Asian proximal femur intramedullary nail antirotation (PFNA-Ⅱ) in the treatment of intertrochanteric fractures in elderly people.Methods From July 2009 to December 2011,127 elderly patients with intertrochanteric fracture were treated by PFNA-Ⅱ.They were 49 cases of male and 78 cases of female,with a mean age of (74.3±15) years.127 elderly patients were classified by modified Evans:type Ⅰ (n=37),typeⅡ (n=42),type Ⅲ (n=26),type Ⅳ (n=15),type V (n=7).We made the statistics on the intraoperative bleeding volume,operation time,incision length,X-light exposure times,and made evaluation of the efficacy of postoperative follow-up and complications by the Harris hip score.Results The average operation time was 42.5 min (35-90) min,the average intraoperative bleeding volume was 107.5 ml (65-410)ml,X-light exposure times were (2.5±1.4) times (2-4) times and the average total incision length was (6.5± 1.8) cm (5.5-11.0) cm.No serious complications or original complications were found during perioperative period.All patients received a 6 to 24 month follow-up (mean 12.5 months in average).The X ray examination showed that the average neck shaft angle was (134±13)° (120°-150°).The average fracture healing time was (14.0±2.5) weeks (11 to 19 weeks).The average hip Harris score was (86.5± 19.5) points (65-100 points).Among them,29 cases (22.83％) were excellent,76 cases (59.8％) were good,20 cases (15.7％) were moderate,2 cases (1.6％) were poor.Totally,excellent and good rate was 82.7％.No complications including hip varus deformity,screw cut-out and femoral shaft fractures were found.There were 14 patients (11.0％) with thigh pain and 5 patients (3.9％) with inner thigh pain.The heavier pain in 4 patients were improved by physical therapy.Conclusions Asian PFNA-Ⅱ has advantages including simple operation,fewer complications,and better clinical efficacy for the treatment of intertrochanteric fractures,but its longterm efficacy and complications still need a large sample and multi-center observation.
