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

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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

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11.	周家铃, 李兵, 李海丰, 等. 股骨近端防旋髓内钉治疗老年股骨转子间骨折的复位技巧[J]. 中华创伤骨科杂志, 2012, 14(4):299-303.
12.	吴刚. 锁定加压钢板治疗老年人股骨粗隆问骨折[J]. 中国中西医结合外科杂志, 2010, 16(1):103.
13.	Kἂἂb 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.	张魁忠,周荣平, 徐聪, 等. 股骨近端锁定钢板治疗股骨粗隆间骨折的疗效探讨[J]. 南方医科大学学报, 2009, 29(12):2561.
15.	王波, 沈光银, 贾志贤, 等. 锁定钢板与股骨近端髓内钉治疗老年股骨粗隆间骨折[J]. 中国骨与关节损伤杂志, 2012, 27(6):526-527.
16.	陶正刚, 韦盛雄, 沈瑞群, 等. 三种不同内固定方式治疗股骨转子间不稳定型骨折的疗效比较[J]. 中华创伤骨科杂志, 2012, 14(2):108-112.

1. Kannus P, Parkkari J, Sievänen 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, 董力军,方兴, 等. 股骨近端锁定钢板治疗老年股骨粗隆间骨折的疗效探讨[J]. 中国基层医药, 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. 刘振宇, 王宝军, 赵亮, 等. 髓内钉固定治疗股骨粗隆间骨折的临床分析[J]. 中国骨与关节损伤杂志, 2011, 26(10):872-873.
9. 胡跃, 王子田,周进林, 等. 抗旋转型股骨近端髓内钉治疗老年股骨粗隆间骨折25例[J].临床军医杂志, 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. 周家铃, 李兵, 李海丰, 等. 股骨近端防旋髓内钉治疗老年股骨转子间骨折的复位技巧[J]. 中华创伤骨科杂志, 2012, 14(4):299-303.
12. 吴刚. 锁定加压钢板治疗老年人股骨粗隆问骨折[J]. 中国中西医结合外科杂志, 2010, 16(1):103.
13. Kἂἂb 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. 张魁忠,周荣平, 徐聪, 等. 股骨近端锁定钢板治疗股骨粗隆间骨折的疗效探讨[J]. 南方医科大学学报, 2009, 29(12):2561.
15. 王波, 沈光银, 贾志贤, 等. 锁定钢板与股骨近端髓内钉治疗老年股骨粗隆间骨折[J]. 中国骨与关节损伤杂志, 2012, 27(6):526-527.
16. 陶正刚, 韦盛雄, 沈瑞群, 等. 三种不同内固定方式治疗股骨转子间不稳定型骨折的疗效比较[J]. 中华创伤骨科杂志, 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

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