Comparison of proximal femoral nail antirotation versus InterTAN nail in the treatment of senile patients with unstable femoral intertrochanteric fracture
10.3760/cma.j.issn.1671-7600.2019.12.007
- VernacularTitle: InterTAN髓内钉与股骨近端防旋髓内钉固定治疗高龄不稳定型股骨转子间骨折的疗效比较
- Author:
Kun ZHANG
1
;
Jiabang LIU
;
Dong LI
;
Qinghua ZHANG
;
Zheng PEI
;
Zhao LI
;
Zhenpeng GUAN
Author Information
1. Department of Orthopaedics, Shougang Hospital Affiliated to Peking University, Beijing 100144, China
- Publication Type:Clinical Trail
- Keywords:
Hip fractures;
Fracture fixation, intramedullary;
Bone nails;
Quality of life
- From:
Chinese Journal of Orthopaedic Trauma
2019;21(12):1052-1058
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy between proximal femoral nail antirotation (PFNA) versus InterTAN nail in the treatment of senile patients with unstable femoral intertrochanteric fracture.
Methods:A retrospective study was conducted of the 164 senile patients with unstable femoral intertrochanteric fracture who had been treated at Department of Orthopedics, Shougang Hospital Affiliated to Peking University from January 2013 to March 2018. InterTAN nailing was performed in 93 of them, including 30 men and 63 women with an age of 84.5±2.4 years; by the AO classification, there were 53 cases of type 31-A2.2, 28 cases of type 31-A2.3 and 12 cases of type 31-A3. PENA fixation was performed in the other 71 patients, including 19 men and 52 women with an age of 83.8±2.3 years; by the AO classification, there were 41 cases of type 31-A2.2, 22 cases of type 31-A2.3 and 8 cases of type 31-A3. The 2 groups were compared in terms of weight-bearing time, thigh pain, hip function, imaging complications and postoperative quality of life.
Results:The 2 groups were comparable because there were no significant differences between them in preoperative general data (P>0.05). In the InterTAN nail group, the incidence of imaging complications [5.4%(5/93)] was significantly lower than in the PFNA group [18.3%(13/71)], the weight-bearing time (60.0±13.6 d) significantly shorter than in the PFNA group (65.8±11.0 d), and the incidence of thigh pain [3.2%(3/93)] significantly lower than in the PFNA group [12.7%(9/71)] (all P< 0.05). Of this series, 153 patients obtained an average follow-up of 39 months (from 12 to 75 months). At the last follow-ups, the Harris scores in the InterTAN nail group (78.3±12.2) were significantly higher than in the PENA group (73.6±11.3) (P<0.05). The InterTAN nail group scored significantly higher in physical functioning (68.6±15.4), general health perceptions (78.2±10.3), vitality (74.0±12.6) and mental health (80.6±9.9) in the 36-item short form health survey (SF-36) than the PFNA groups did (64.1±9.9, 74.9±9.0, 69.9±10.9 and 77.4±8.8) (all P<0.05).
Conclusions:Both internal fixation procedures are able to heal the fracture and restore the hip function in the senile patients with unstable femoral intertrochanteric fracture. However, InterTAN nail may have the advantages of earlier weight-bearing, lower incidence of varus deformity and better recovery of postoperative quality of life.
