Efficacy of different operative positions on Asian proximal femoral anti-rotation intramedullary nail for femoral intertrochanteric fracture in the elderly
10.3760/cma.j.issn.1001-8050.2018.09.009
- VernacularTitle:不同手术体位下亚洲型股骨近端防旋髓内钉治疗老年股骨转子间骨折的疗效比较
- Author:
Ming ZHU
1
;
Shuqing ZHOU
Author Information
1. 重庆市江津区中心医院骨科
- Keywords:
Femoral fractures;
Posture;
Fracture fixation,internal;
Asian proximal femur intramedullary nail antirotation system
- From:
Chinese Journal of Trauma
2018;34(9):821-826
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy between supine position and latericumbent position on Asian proximal femoral nail anti-rotation (PFNA-Ⅱ) fixation for femoral intertrochanteric fracture in elderly patients.Methods A retrospective case control study was conducted to analyze the clinical data of 128 patients with intertrochanteric fractures admitted from January 2016 to January 2017.There were 49 males and 79 females,aged 65-100 years,with an average of 83.2 years.According to AO classification of fracture,there were 27 cases of type A1,82 cases of type A2,and 19 cases of type A3.The patients were divided in to supine position group at traction bed (66 cases) and latericumbent position group at regular bed (62 cases) according to the operative position.The two groups were treated with Asian PFNA-Ⅱ internal fixation.The position time,incision length,operation time,intraoperative blood loss,ambulation time without load,fracture healing time,and Harris score of hip function at the last follow up were compared between the two groups.Complications were recorded.Results All patients were followed up for 12-18 months,with an average of 13.5 months.There were no significant differences between the two groups inambulation time without load,fracture healing time,and Harris score of hip joint function (P ＞ 0.05).In the supine position group and the latericumbent position group,respectively,the position time was (13.6 ± 2.3)minutes and (6.4 ± 1.6) minutes,the incision length was (7.8 ± 1.9) cm and (6.5 ± 1.4) cm,the operation time was (51.3 ± 4.1) minutes and (45.5 ± 5.5) minutes,the intraoperative blood loss was (99.5 ± 3.5) ml and (82.1 ±3.5) ml (P ＜ 0.05 or 0.01).All patients were healed without complications such as coxa varus,internal fixation loosening or fracture.Conclusion The Asian PFNA-Ⅱ internal fixation in the latericumbent position for senile intertrochanteric fractures has the advantages of simple procedure,less trauma,shorter operation time,and less bleeding,which is worthy of promotion.
