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, 蔡贤华, 李稳, 等. 老年股骨转子间骨折围手术期隐性失血量与性别、内固定方式的相关性分析. 中华创伤骨科杂志, 2015, 17(2):134-137.
2.	柴瑞宝. PFNA与解剖型锁定钢板治疗老年人股骨粗隆间骨折的临床比较研究. 中国矫形外科杂志, 2015, 23(16):1481-1484.
3.	刘景一, 杨晓飞, 贺新兵, 等. 股骨近端螺旋刀片抗旋髓内钉治疗股骨粗隆间骨折的并发症及其防治. 中国矫形外科杂志, 2014, 22(22):2105-2107.
4.	刘景一, 闫军, 豆青军, 等. 骨水泥型人工髋关节置换治疗首次治疗失败的高龄股骨转子间骨折. 中华创伤骨科杂志, 2015, 17(5):455-457.
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6.	杨飞, 韩启明, 杨凤明, 等. 老年股骨粗隆间骨折微创INTERTAN髓内钉与PFNA-Ⅱ髓内钉临床疗效分析. 中国矫形外科杂志, 2015, 23(10):897-901.
7.	张秋香, 胡小花. 单腿低截石位在股骨粗隆骨折内固定术摄片中运用. 医学信息, 2015, 28(31):311.
8.	朱峰, 郭德全, 孔德宏. 双动股骨头置换与股骨近端锁定钢板治疗高龄股骨转子间粉碎性骨折的疗效. 江苏医药, 2015, 41(14):1698-1700.
9.	陈勤, 周政, 关龙, 等. Gamma钉治疗股骨转子间骨折两种手术方法的临床比较. 中国修复重建外科杂志, 2007, 21(10):1027-1030.
10.	黄晋, 杨松杰, 罗勤瑜, 等. 侧卧位与平卧位下股骨近端防旋髓内钉治疗肥胖患者股骨转子间骨折的疗效比较. 中华创伤骨科杂志, 2014, 16(4):364-366.
11.	黄晋, 吴漾, 邱雪立. 侧卧位和仰卧位PFNA治疗股骨粗隆骨折的比较. 实用医学杂志, 2011, 27(21):3914-3916.
12.	郭元利, 胡宝山, 芮钢, 等. 侧卧位置入PFN内固定治疗股骨粗隆间骨折的可行性研究. 中国骨与关节损伤杂志, 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. 正确认识关节置换治疗股骨转子间骨折. 中华创伤杂志, 2015, 31(1):3-6.
15.	牛会彬, 刘中国, 邓岗西. 2种C型臂X线机透视方法在股骨粗隆间骨折PFNA内固定术中应用比较. 中国骨与关节损伤杂志, 2014, 29(2):174-175.
16.	张培训, 党育, 薛峰, 等. 股骨近端防旋髓内钉治疗股骨转子间骨折中显性和隐性失血量分析. 中华创伤杂志, 2011, 27(9):785-788.
17.	王建卫, 严世贵. 老年股骨转子间骨折手术治疗若干问题探讨. 中国骨伤, 2013, 26(12):973-976.

1. 曾晶山, 蔡贤华, 李稳, 等. 老年股骨转子间骨折围手术期隐性失血量与性别、内固定方式的相关性分析. 中华创伤骨科杂志, 2015, 17(2):134-137.
2. 柴瑞宝. PFNA与解剖型锁定钢板治疗老年人股骨粗隆间骨折的临床比较研究. 中国矫形外科杂志, 2015, 23(16):1481-1484.
3. 刘景一, 杨晓飞, 贺新兵, 等. 股骨近端螺旋刀片抗旋髓内钉治疗股骨粗隆间骨折的并发症及其防治. 中国矫形外科杂志, 2014, 22(22):2105-2107.
4. 刘景一, 闫军, 豆青军, 等. 骨水泥型人工髋关节置换治疗首次治疗失败的高龄股骨转子间骨折. 中华创伤骨科杂志, 2015, 17(5):455-457.
5. 邱贵兴, 戴尅戎. 骨科手术学. 3版. 北京:人民卫生出版社, 2006.
6. 杨飞, 韩启明, 杨凤明, 等. 老年股骨粗隆间骨折微创INTERTAN髓内钉与PFNA-Ⅱ髓内钉临床疗效分析. 中国矫形外科杂志, 2015, 23(10):897-901.
7. 张秋香, 胡小花. 单腿低截石位在股骨粗隆骨折内固定术摄片中运用. 医学信息, 2015, 28(31):311.
8. 朱峰, 郭德全, 孔德宏. 双动股骨头置换与股骨近端锁定钢板治疗高龄股骨转子间粉碎性骨折的疗效. 江苏医药, 2015, 41(14):1698-1700.
9. 陈勤, 周政, 关龙, 等. Gamma钉治疗股骨转子间骨折两种手术方法的临床比较. 中国修复重建外科杂志, 2007, 21(10):1027-1030.
10. 黄晋, 杨松杰, 罗勤瑜, 等. 侧卧位与平卧位下股骨近端防旋髓内钉治疗肥胖患者股骨转子间骨折的疗效比较. 中华创伤骨科杂志, 2014, 16(4):364-366.
11. 黄晋, 吴漾, 邱雪立. 侧卧位和仰卧位PFNA治疗股骨粗隆骨折的比较. 实用医学杂志, 2011, 27(21):3914-3916.
12. 郭元利, 胡宝山, 芮钢, 等. 侧卧位置入PFN内固定治疗股骨粗隆间骨折的可行性研究. 中国骨与关节损伤杂志, 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. 正确认识关节置换治疗股骨转子间骨折. 中华创伤杂志, 2015, 31(1):3-6.
15. 牛会彬, 刘中国, 邓岗西. 2种C型臂X线机透视方法在股骨粗隆间骨折PFNA内固定术中应用比较. 中国骨与关节损伤杂志, 2014, 29(2):174-175.
16. 张培训, 党育, 薛峰, 等. 股骨近端防旋髓内钉治疗股骨转子间骨折中显性和隐性失血量分析. 中华创伤杂志, 2011, 27(9):785-788.
17. 王建卫, 严世贵. 老年股骨转子间骨折手术治疗若干问题探讨. 中国骨伤, 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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