Application of Lateral Wall Protection for Intertrochanteric Fractures Fixed with Proximal Femoral Nail Antirotation_West China Medical Journal

Authors：

 ZHANGXi-hai , ZHUONai-qiang ,  LUXiao-bo

Department of Bone and Joint Surgery, the First Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan 646000, P. R. China;

Corresponding?author：

LUXiao-bo, Email: luxiaobo1963@126.com

Keywords：

Lateral wall; Intertrochanteric fracture; Proximal femoral nail antirotation

DOI：

10.7507/1002-0179.20140079

Video：

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Objective To investigate the lateral wall protection skills for aged femoral intertrochanteric fractures fixed with proximal femoral nail antirotation (PFNA). Methods Sixty aged patients with femoral intertrochanteric fractures were treated with PFNA between March 210 and January 2011.According to Evans classification,31 were type Ⅰc,18 were Ⅰd,and 11 were type Ⅱ.Several skills were applied to prevent the breaking of the lateral wall.Post-operative complications,bone union and recovery of hip function were recorded. Results The patients were followed up for 12 to 18 months.All fractures were healed without infection or failure of internal fixation. Conclusion PFNA is a good choice for the clinical treatment of unstable femoral intertrochanteric fractures in aged patients.To obtain better clinical result,the lateral wall must be considered and well protected.

Citation： ZHANGXi-hai, ZHUONai-qiang, LUXiao-bo. Application of Lateral Wall Protection for Intertrochanteric Fractures Fixed with Proximal Femoral Nail Antirotation. West China Medical Journal, 2014, 29(2): 256-258. doi: 10.7507/1002-0179.20140079 Copy

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2.	黃俊,紀方,曹磊,等.DHS、Gamma釘和PFNA治療老年骨質疏松性股骨粗隆間骨折[J].第二軍醫大學學報,2008,29(10):1261-1263.
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4.	劉永強,范金鵬,高蘭芳,等.PFNA與DHS治療不穩定性股骨粗隆間骨折療效分析[J].實用骨科雜志,2011,17(8):742-744.
5.	顧春生,崇漢卿.股骨粗隆間骨折不同內固定術式的療效分析[J].中國骨與關節損傷雜志,2011,26(12):1107-1108.
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8.	張根福,王正明,鮑豐,等.股骨近端抗旋髓內釘在股骨轉子周圍骨折中的應用[J].中華創傷雜志,2010,26(8):709-712.
9.	張東,張廷玖,庾明.閉合復位PFNA內固定治療股骨粗隆間骨折[J].重慶醫學,2010,39(18):2543-2544.
10.	吳崗,方躍,裴福興,等.PFNA治療老年股骨轉子間骨折29例體會[J].華西醫學,2009,24(6):1539-1541.
11.	唐佩福,姚琦,黃鵬,等.股骨近端髓內釘-螺旋刀片治療高齡骨質疏松性股骨轉子間骨折[J].中華創傷骨科雜志,2007,9(7):622-624.
12.	Gotfried Y.The lateral trochanteric wall:a key element in the reconstruction of unstable pertrochanteric hip fractures[J].Clin Orthop Relat Res,2004(425):82-86.
13.	Palm H,Jacobsen S,Sonne-Holm S,et al.Integrity of the lateral femoral wall in intertrochanteric hip fractures:an important predictor of a reoperation[J].J Bone Joint Surg Am,2007,89(3):470-475.
14.	Langford J,Pillai G,Ugliailoro AD,et al.Perioperative lateral trochanteric wall fractures:sliding hip screw versus percutaneous compression plate for intertrochanteric hip fractures[J].J Orthop Trauma,2011,25(4):191-195.
15.	張世民,祝曉忠,黃軼剛,等.外側壁危險型股骨粗隆間骨折DHS與PFNA治療的回顧性對比研究[J].中國矯形外科雜志,2010,18(22):1868-1872.

1. 梁雨田,唐佩福.老年髖部骨折[M].北京:人民軍醫出版社,2009:61-62.
2. 黃俊,紀方,曹磊,等.DHS、Gamma釘和PFNA治療老年骨質疏松性股骨粗隆間骨折[J].第二軍醫大學學報,2008,29(10):1261-1263.
3. 鄭紅根,唐昊,張秋林.兩種不同內固定治療股骨粗隆間骨折的比較研究[J].中國矯形外科雜志,2009,17(6):407-410.
4. 劉永強,范金鵬,高蘭芳,等.PFNA與DHS治療不穩定性股骨粗隆間骨折療效分析[J].實用骨科雜志,2011,17(8):742-744.
5. 顧春生,崇漢卿.股骨粗隆間骨折不同內固定術式的療效分析[J].中國骨與關節損傷雜志,2011,26(12):1107-1108.
6. 魏朝陽,趙文,周忠鴻.股骨近端抗旋髓內釘在老年股骨粗隆間骨折治療中的應用[J].華西醫學,2012,27(7):1061-1062.
7. 王海全,田金鳳,焦玉峰.股骨近端防旋髓內釘內固定術治療老年股骨粗隆間骨折[J].山東醫藥,2011,51(46):105-106.
8. 張根福,王正明,鮑豐,等.股骨近端抗旋髓內釘在股骨轉子周圍骨折中的應用[J].中華創傷雜志,2010,26(8):709-712.
9. 張東,張廷玖,庾明.閉合復位PFNA內固定治療股骨粗隆間骨折[J].重慶醫學,2010,39(18):2543-2544.
10. 吳崗,方躍,裴福興,等.PFNA治療老年股骨轉子間骨折29例體會[J].華西醫學,2009,24(6):1539-1541.
11. 唐佩福,姚琦,黃鵬,等.股骨近端髓內釘-螺旋刀片治療高齡骨質疏松性股骨轉子間骨折[J].中華創傷骨科雜志,2007,9(7):622-624.
12. Gotfried Y.The lateral trochanteric wall:a key element in the reconstruction of unstable pertrochanteric hip fractures[J].Clin Orthop Relat Res,2004(425):82-86.
13. Palm H,Jacobsen S,Sonne-Holm S,et al.Integrity of the lateral femoral wall in intertrochanteric hip fractures:an important predictor of a reoperation[J].J Bone Joint Surg Am,2007,89(3):470-475.
14. Langford J,Pillai G,Ugliailoro AD,et al.Perioperative lateral trochanteric wall fractures:sliding hip screw versus percutaneous compression plate for intertrochanteric hip fractures[J].J Orthop Trauma,2011,25(4):191-195.
15. 張世民,祝曉忠,黃軼剛,等.外側壁危險型股骨粗隆間骨折DHS與PFNA治療的回顧性對比研究[J].中國矯形外科雜志,2010,18(22):1868-1872.

West China Medical Journal

Application of Lateral Wall Protection for Intertrochanteric Fractures Fixed with Proximal Femoral Nail Antirotation

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