EFFECTIVENESS COMPARISON OF PROXIMAL FEMORAL NAIL ANTI-ROTATION IN SUPINE “SCISSORS” POSITION AND IN LITHOTOMY POSITION TO TREAT FEMORAL INTERTROCHANTERIC FRACTURES OF OLD PATIENTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DUShihao ,  YINFei , WEIXuming , SONGSheng , GUSanjun , SUNZhenzhong , RUIYongjun

Department of Orthopaedics, No. 9 People's Hospital of Wuxi Affiliated to Soochow University, Wuxi Jiangsu, 214000, P. R. China;

Corresponding?author：

YINFei, Email: yfseu0126@126.com

Keywords：

Femoral intertrochanteric fracture; Internal fixation; Supine "scissors" position; Lithotomy position; Old patient

DOI：

10.7507/1002-1892.20160031

Video：

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Objective To compare the effectiveness of proximal femoral nail anti-rotation (PFNA) between in the supine "scissors" position and in the lithotomy position for treating femoral intertrochanteric fractures of old patients. Methods A retrospective study was performed on 58 patients with femoral intertrochanteric fractures treated with PFNA between January 2013 and January 2015. Fracture was treated with PFNA in the lithotomy position in 28 cases (group A) and in the supine "scissors" position in 30 cases (group B). There was no significant difference in gender, age, side, cause of injury, fracture type, and interval from injury to operation between 2 groups (P>0.05). The incision length, operation time, perspective times, intraoperative blood loss, complications, and fracture healing time were recorded; Harris hip score was used to access the effectiveness. Results The wound healed by first intention without infection, pressure sores, deep vein thrombosis of lower extremity, and other complications. There was no significant difference in incision length between 2 groups (t=1.313, P=0.212). Group B was significantly better than group A in operation time, perspective times, and intraoperative blood loss (P<0.05). All patients were followed up 10-31 months (mean, 15.3 months). Stretch injury at normal side and perineal discomfort occurred in 1 case and 5 cases of group A respectively, and no nonunion and other complications was observed in the other patients. There was no significant difference in fracture healing time and Harris hip score at last follow-up between 2 groups (P>0.05). Conclusion PFNA in the supine "scissors" position has exact effectiveness and advantages of shorter operation time, less intraoperative blood loss, less perspective times, and fewer complications.

Citation： DUShihao, YINFei, WEIXuming, SONGSheng, GUSanjun, SUNZhenzhong, RUIYongjun. EFFECTIVENESS COMPARISON OF PROXIMAL FEMORAL NAIL ANTI-ROTATION IN SUPINE “SCISSORS” POSITION AND IN LITHOTOMY POSITION TO TREAT FEMORAL INTERTROCHANTERIC FRACTURES OF OLD PATIENTS. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(2): 152-155. doi: 10.7507/1002-1892.20160031 Copy

1.	?曾晶山, 蔡賢華, 李穩, 等. 老年股骨轉子間骨折圍手術期隱性失血量與性別、內固定方式的相關性分析. 中華創傷骨科雜志, 2015, 17(2):134-137.
2.	柴瑞寶. PFNA與解剖型鎖定鋼板治療老年人股骨粗隆間骨折的臨床比較研究. 中國矯形外科雜志, 2015, 23(16):1481-1484.
3.	劉景一, 楊曉飛, 賀新兵, 等. 股骨近端螺旋刀片抗旋髓內釘治療股骨粗隆間骨折的并發癥及其防治. 中國矯形外科雜志, 2014, 22(22):2105-2107.
4.	劉景一, 閆軍, 豆青軍, 等. 骨水泥型人工髖關節置換治療首次治療失敗的高齡股骨轉子間骨折. 中華創傷骨科雜志, 2015, 17(5):455-457.
5.	邱貴興, 戴尅戎. 骨科手術學. 3版. 北京:人民衛生出版社, 2006.
6.	楊飛, 韓啟明, 楊鳳明, 等. 老年股骨粗隆間骨折微創INTERTAN髓內釘與PFNA-Ⅱ髓內釘臨床療效分析. 中國矯形外科雜志, 2015, 23(10):897-901.
7.	張秋香, 胡小花. 單腿低截石位在股骨粗隆骨折內固定術攝片中運用. 醫學信息, 2015, 28(31):311.
8.	朱峰, 郭德全, 孔德宏. 雙動股骨頭置換與股骨近端鎖定鋼板治療高齡股骨轉子間粉碎性骨折的療效. 江蘇醫藥, 2015, 41(14):1698-1700.
9.	陳勤, 周政, 關龍, 等. Gamma釘治療股骨轉子間骨折兩種手術方法的臨床比較. 中國修復重建外科雜志, 2007, 21(10):1027-1030.
10.	黃晉, 楊松杰, 羅勤瑜, 等. 側臥位與平臥位下股骨近端防旋髓內釘治療肥胖患者股骨轉子間骨折的療效比較. 中華創傷骨科雜志, 2014, 16(4):364-366.
11.	黃晉, 吳漾, 邱雪立. 側臥位和仰臥位PFNA治療股骨粗隆骨折的比較. 實用醫學雜志, 2011, 27(21):3914-3916.
12.	郭元利, 胡寶山, 芮鋼, 等. 側臥位置入PFN內固定治療股骨粗隆間骨折的可行性研究. 中國骨與關節損傷雜志, 2012, 27(12):1108-1109.
13.	Xue L, Zha L, Chen Q, et al. Randomized controlled trials of proximal femoral nail antirotation in lateral decubitus and supine position on treatment of intertrochanteric fractures. Scientific World Journal, 2013, 2013:276015.
14.	童培建. 正確認識關節置換治療股骨轉子間骨折. 中華創傷雜志, 2015, 31(1):3-6.
15.	牛會彬, 劉中國, 鄧崗西. 2種C型臂X線機透視方法在股骨粗隆間骨折PFNA內固定術中應用比較. 中國骨與關節損傷雜志, 2014, 29(2):174-175.
16.	張培訓, 黨育, 薛峰, 等. 股骨近端防旋髓內釘治療股骨轉子間骨折中顯性和隱性失血量分析. 中華創傷雜志, 2011, 27(9):785-788.
17.	王建衛, 嚴世貴. 老年股骨轉子間骨折手術治療若干問題探討. 中國骨傷, 2013, 26(12):973-976.

1. ?曾晶山, 蔡賢華, 李穩, 等. 老年股骨轉子間骨折圍手術期隱性失血量與性別、內固定方式的相關性分析. 中華創傷骨科雜志, 2015, 17(2):134-137.
2. 柴瑞寶. PFNA與解剖型鎖定鋼板治療老年人股骨粗隆間骨折的臨床比較研究. 中國矯形外科雜志, 2015, 23(16):1481-1484.
3. 劉景一, 楊曉飛, 賀新兵, 等. 股骨近端螺旋刀片抗旋髓內釘治療股骨粗隆間骨折的并發癥及其防治. 中國矯形外科雜志, 2014, 22(22):2105-2107.
4. 劉景一, 閆軍, 豆青軍, 等. 骨水泥型人工髖關節置換治療首次治療失敗的高齡股骨轉子間骨折. 中華創傷骨科雜志, 2015, 17(5):455-457.
5. 邱貴興, 戴尅戎. 骨科手術學. 3版. 北京:人民衛生出版社, 2006.
6. 楊飛, 韓啟明, 楊鳳明, 等. 老年股骨粗隆間骨折微創INTERTAN髓內釘與PFNA-Ⅱ髓內釘臨床療效分析. 中國矯形外科雜志, 2015, 23(10):897-901.
7. 張秋香, 胡小花. 單腿低截石位在股骨粗隆骨折內固定術攝片中運用. 醫學信息, 2015, 28(31):311.
8. 朱峰, 郭德全, 孔德宏. 雙動股骨頭置換與股骨近端鎖定鋼板治療高齡股骨轉子間粉碎性骨折的療效. 江蘇醫藥, 2015, 41(14):1698-1700.
9. 陳勤, 周政, 關龍, 等. Gamma釘治療股骨轉子間骨折兩種手術方法的臨床比較. 中國修復重建外科雜志, 2007, 21(10):1027-1030.
10. 黃晉, 楊松杰, 羅勤瑜, 等. 側臥位與平臥位下股骨近端防旋髓內釘治療肥胖患者股骨轉子間骨折的療效比較. 中華創傷骨科雜志, 2014, 16(4):364-366.
11. 黃晉, 吳漾, 邱雪立. 側臥位和仰臥位PFNA治療股骨粗隆骨折的比較. 實用醫學雜志, 2011, 27(21):3914-3916.
12. 郭元利, 胡寶山, 芮鋼, 等. 側臥位置入PFN內固定治療股骨粗隆間骨折的可行性研究. 中國骨與關節損傷雜志, 2012, 27(12):1108-1109.
13. Xue L, Zha L, Chen Q, et al. Randomized controlled trials of proximal femoral nail antirotation in lateral decubitus and supine position on treatment of intertrochanteric fractures. Scientific World Journal, 2013, 2013:276015.
14. 童培建. 正確認識關節置換治療股骨轉子間骨折. 中華創傷雜志, 2015, 31(1):3-6.
15. 牛會彬, 劉中國, 鄧崗西. 2種C型臂X線機透視方法在股骨粗隆間骨折PFNA內固定術中應用比較. 中國骨與關節損傷雜志, 2014, 29(2):174-175.
16. 張培訓, 黨育, 薛峰, 等. 股骨近端防旋髓內釘治療股骨轉子間骨折中顯性和隱性失血量分析. 中華創傷雜志, 2011, 27(9):785-788.
17. 王建衛, 嚴世貴. 老年股骨轉子間骨折手術治療若干問題探討. 中國骨傷, 2013, 26(12):973-976.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS COMPARISON OF PROXIMAL FEMORAL NAIL ANTI-ROTATION IN SUPINE “SCISSORS” POSITION AND IN LITHOTOMY POSITION TO TREAT FEMORAL INTERTROCHANTERIC FRACTURES OF OLD PATIENTS

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