Efficacy of a New Intramedullary Fixation System Proximal Femoral Universal Nail in the Treatment of Intertrochanteric Femoral Fractures in Elderly Patients
10.3969/j.issn.1009-6604.2025.06.002
- VernacularTitle:新型髓内固定系统股骨近端通用髓内钉治疗老年患者股骨转子间骨折的疗效
- Author:
Yuan CAO
1
;
Jixing FAN
1
;
Zengzhen CUI
1
;
Zhongwei YANG
1
;
Yang LV
1
;
Yun TIAN
1
;
Fang ZHOU
1
Author Information
1. 北京大学第三医院骨科 骨与关节精准医学教育部工程研究中心,北京 100191
- Publication Type:Journal Article
- Keywords:
Intertrochanteric femoral fractures;
Elderly patients;
Proximal femoral universal nail;
Failure of internal fixation
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(6):329-334
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of proximal femoral universal nail(PFUN),a new type of intramedullary fixation system,in the treatment of acute unilateral intertrochanteric femoral fracture in elderly patients.Methods From January 2022 to January 2024,200 patients with acute unilateral femoral intertrochanteric fracture were treated in our department.After closed traction reduction,PFUN was implanted with small incisions.Unified rehabilitation plan was adopted after surgery.The functional evaluation was performed by using the Harris hip score system at the last follow-up.Results The operation time was 25-182 min(median,63.0 min).The intraoperative blood loss was 10-750 ml(median,50.0 ml).Intraoperative blood transfusion(suspension of red blood cells)was required in 40 cases(20％).The postoperative hospital stay was 1-15 d(mean,4.0±1.9 d).The postoperative femoral neck-shaft angle was 116.7°-140.1°(mean,132.4°±5.5°).The quality of fracture reduction on the first day after surgery showed 140 cases as excellent,54 cases acceptable,and 6 cases poor.Complications occurred in 13 cases,including superficial wound infection in 2 cases,who were cured by regular wound dressing change and antibiotic treatment,lower extremity deep vein thrombosis in 8 cases,who were given low molecular weight heparin anticoagulation treatment until improvement,pneumonia in 2 cases and urinary tract infection in 1 case,who were cured or improved after specialist treatment.At one month after surgery,the hip joint X-ray showed blurred fracture lines,callus formation at the fracture site,and no internal fixation failure.There was no internal fixation failure within 3 months after surgery.At six months after surgery,all fractures achieved healing without any failure of internal fixation.All the 200 cases were followed up for 12-29 months(mean,16.1±2.7 months).One case experienced internal fixation failure,and underwent head and neck screw resection,internal fixation removal and hip replacement.At the last follow-up,the postoperative recovery was satisfactory.The Harris score of hip joint was 70-94 points(mean,88.8±2.8 points),including 103 cases as excellent,92 cases good,and 5 cases fair,with an excellent and good rate of 97.5％(195/200).Conclusion PFUN is effective in the treatment of intertrochanteric femoral fractures in elderly patients,with reliable fixation,rapid postoperative recovery,and low failure rate of internal fixation,especially suitable for unstable cases with internal or external wall fractures.
