Contrast between the Curative Effect of Proximal Femoral Nail Antirotation and Locking Proximal Femoral Plate for Femoral Intertrochanteric Fracture in Senile Patients_West China Medical Journal

Authors：

 MAOXian-fa ¹ , ZHULi-jun ¹ , SONGXiao-yan ¹ , LIHong ¹ , YANGLin ¹ , DAIShou-zhi ¹ , ZHAOLin ¹ , QINYi ¹ , FANGYue ²

1. Department of Orthopedics, People's Hospital of Wenjiang District, Chengdu, Sichuan 611130, P. R. China;
2. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

Keywords：

Proximal femoral nail antirotation; Locking proximal femoral plate; Senile patients; Femoral intertrochanteric fracture

DOI：

10.7507/1002-0179.20150349

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the clinical effect of proximal femoral nail antirotation (PFNA) and locking proximal femoral plate (LPFP) for femoral intertrochanteric fracture in elderly patients. Methods We respectively analyzed the clinical data of 116 senile patients with femoral intertrochanteric fracture treated between October 2008 and March 2014. Among them, 60 were treated with PFNA, and 56 were treated with LPFP. We compared the two groups of patients in terms of operating time, surgical blood loss, surgical complications, walking exercise time, fracture healing time and joint function recovery. Results A total of 115 patients had regular follow-up from 12 to 24 months (averaging 15.7 months). One patient died. The operating time was (83.26±14.81) minutes in PFNA group and (102.58±15.31) minutes in LPFP group. The surgical blood loss was (202.16±33.14) mL in PFNA group and (255.80±45.92) mL in LPFP group. The walking exercise time was (1.80±0.91) weeks in PFNA group and (3.48±3.03) weeks in LPFP group. The fracture healing time was (11.80±2.26) weeks in PFNA group and (12.14±2.21) weeks in LPFP group. The postoperative Harris score for hip joint was 84.56±9.55 in PFNA group and 82.47±9.22 in LPFP group. There were statistical differences in operating time, surgical blood loss and walking exercise time (P<0.05), while no statistical differences were found in fracture healing time and postoperative Harris score for hip joint (P>0.05). Conclusion PFNA and LPFP are effective methods for femoral intertrochanteric fracture in elderly people, but PFNA has a shorter operating time, less surgical blood loss and earlier walking exercise time.

Citation： MAOXian-fa, ZHULi-jun, SONGXiao-yan, LIHong, YANGLin, DAIShou-zhi, ZHAOLin, QINYi, FANGYue. Contrast between the Curative Effect of Proximal Femoral Nail Antirotation and Locking Proximal Femoral Plate for Femoral Intertrochanteric Fracture in Senile Patients. West China Medical Journal, 2015, 30(7): 1209-1212. doi: 10.7507/1002-0179.20150349 Copy

1.	Kannus P, Parkkari J, Siev?nen H, et al. Epidemiology of hip fracture[J]. Bone, 1961, 18(Supple 1):S57-S63.
2.	Kanis JA, OdencA, Johnell O et al. The components of excess mortality after hip fracture[J]. Bone, 2003, 32(5):323-324.
3.	Efstathopoulos NS, Nikolaos VS, Lazarettos JT. Intramedullary fixation of intertrochanteric hip fractures:a comparison of two implant designs[J]. Int Orthop, 2007, 31(1):71-76.
4.	王微, 董力軍,方興, 等. 股骨近端鎖定鋼板治療老年股骨粗隆間骨折的療效探討[J]. 中國基層醫藥, 2010, 17(24):3335-3337.
5.	Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty. An end-result study using a new method of result evaluation[J]. J Bone Joint Surg Am, 1969, 51(4):737-755.
6.	Giancola R, Antonini G, Delle RG, et al. Percutaneous compression plating versus gamma nail for treatment of pertrochanteric hip fractures[J]. Strategies Trauma Limb Reconstr, 2008, 3(1):9-14.
7.	Strauss E, Frank J, Lee J, et al. Helical blade versus sliding hip screw for treatment of unstable intertrochanteric hip fractures:a biomechanical evaluation[J]. Injury, 2006, 37(10):984-989.
8.	劉振宇, 王寶軍, 趙亮, 等. 髓內釘固定治療股骨粗隆間骨折的臨床分析[J]. 中國骨與關節損傷雜志, 2011, 26(10):872-873.
9.	胡躍, 王子田,周進林, 等. 抗旋轉型股骨近端髓內釘治療老年股骨粗隆間骨折25例[J].臨床軍醫雜志, 2013, 41(3):237-238, 241.
10.	Moein CM, Verhofstad MH, Bleys RL, et al. Soft tissue injury related to choice of entry point in antegrade femoral nailing:piriform fossa or greater trochanter tip[J]. Injury, 2005, 36(11):1337-1342.
11.	周家鈴, 李兵, 李海豐, 等. 股骨近端防旋髓內釘治療老年股骨轉子間骨折的復位技巧[J]. 中華創傷骨科雜志, 2012, 14(4):299-303.
12.	吳剛. 鎖定加壓鋼板治療老年人股骨粗隆問骨折[J]. 中國中西醫結合外科雜志, 2010, 16(1):103.
13.	K??b MJ, Frenk A, Schmeling A, et al. Loceel internal fixator:sensitivity of screw/plate stability to the correct insertion angle of the screw[J]. J Orthop Trauma, 2004, 18(8):483-487.
14.	張魁忠,周榮平, 徐聰, 等. 股骨近端鎖定鋼板治療股骨粗隆間骨折的療效探討[J]. 南方醫科大學學報, 2009, 29(12):2561.
15.	王波, 沈光銀, 賈志賢, 等. 鎖定鋼板與股骨近端髓內釘治療老年股骨粗隆間骨折[J]. 中國骨與關節損傷雜志, 2012, 27(6):526-527.
16.	陶正剛, 韋盛雄, 沈瑞群, 等. 三種不同內固定方式治療股骨轉子間不穩定型骨折的療效比較[J]. 中華創傷骨科雜志, 2012, 14(2):108-112.

1. Kannus P, Parkkari J, Siev?nen H, et al. Epidemiology of hip fracture[J]. Bone, 1961, 18(Supple 1):S57-S63.
2. Kanis JA, OdencA, Johnell O et al. The components of excess mortality after hip fracture[J]. Bone, 2003, 32(5):323-324.
3. Efstathopoulos NS, Nikolaos VS, Lazarettos JT. Intramedullary fixation of intertrochanteric hip fractures:a comparison of two implant designs[J]. Int Orthop, 2007, 31(1):71-76.
4. 王微, 董力軍,方興, 等. 股骨近端鎖定鋼板治療老年股骨粗隆間骨折的療效探討[J]. 中國基層醫藥, 2010, 17(24):3335-3337.
5. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty. An end-result study using a new method of result evaluation[J]. J Bone Joint Surg Am, 1969, 51(4):737-755.
6. Giancola R, Antonini G, Delle RG, et al. Percutaneous compression plating versus gamma nail for treatment of pertrochanteric hip fractures[J]. Strategies Trauma Limb Reconstr, 2008, 3(1):9-14.
7. Strauss E, Frank J, Lee J, et al. Helical blade versus sliding hip screw for treatment of unstable intertrochanteric hip fractures:a biomechanical evaluation[J]. Injury, 2006, 37(10):984-989.
8. 劉振宇, 王寶軍, 趙亮, 等. 髓內釘固定治療股骨粗隆間骨折的臨床分析[J]. 中國骨與關節損傷雜志, 2011, 26(10):872-873.
9. 胡躍, 王子田,周進林, 等. 抗旋轉型股骨近端髓內釘治療老年股骨粗隆間骨折25例[J].臨床軍醫雜志, 2013, 41(3):237-238, 241.
10. Moein CM, Verhofstad MH, Bleys RL, et al. Soft tissue injury related to choice of entry point in antegrade femoral nailing:piriform fossa or greater trochanter tip[J]. Injury, 2005, 36(11):1337-1342.
11. 周家鈴, 李兵, 李海豐, 等. 股骨近端防旋髓內釘治療老年股骨轉子間骨折的復位技巧[J]. 中華創傷骨科雜志, 2012, 14(4):299-303.
12. 吳剛. 鎖定加壓鋼板治療老年人股骨粗隆問骨折[J]. 中國中西醫結合外科雜志, 2010, 16(1):103.
13. K??b MJ, Frenk A, Schmeling A, et al. Loceel internal fixator:sensitivity of screw/plate stability to the correct insertion angle of the screw[J]. J Orthop Trauma, 2004, 18(8):483-487.
14. 張魁忠,周榮平, 徐聰, 等. 股骨近端鎖定鋼板治療股骨粗隆間骨折的療效探討[J]. 南方醫科大學學報, 2009, 29(12):2561.
15. 王波, 沈光銀, 賈志賢, 等. 鎖定鋼板與股骨近端髓內釘治療老年股骨粗隆間骨折[J]. 中國骨與關節損傷雜志, 2012, 27(6):526-527.
16. 陶正剛, 韋盛雄, 沈瑞群, 等. 三種不同內固定方式治療股骨轉子間不穩定型骨折的療效比較[J]. 中華創傷骨科雜志, 2012, 14(2):108-112.

West China Medical Journal

Contrast between the Curative Effect of Proximal Femoral Nail Antirotation and Locking Proximal Femoral Plate for Femoral Intertrochanteric Fracture in Senile Patients

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content