A comparative biomechanical study of proximal femoral nail (InterTAN) and proximal femoral nail antirotation for intertrochanteric fractures

Purpose

The purpose of this study was to compare the biomechanical strength of the cephalomedullary nail InterTAN in cases of intertrochanteric fractures with the commonly used PFNA.

Methods

Sixteen fresh specimens of the proximal femur were used as intertrochanteric fracture models and were fixed using two fixation devices: the new proximal femoral nail (InterTAN) and proximal femoral nail antirotation (PFNA). An intertrochanteric fracture was created in composite bone models. Each specimen was loaded to simulate single leg stance while stiffness, migration (cut out), compressive force across the fracture site, and distal fragment rotation were monitored. The different internal fixation methods were tested by an experimental press analysis.

Results

Results of tests for femoral strength, stiffness, stability, and bearing capacity demonstrated that the biomechanical function of InterTAN was better than that of PFNA (P < 0.05). Compared with the PFNA nail, InterTAN showed increased strength, stiffness, and resistance torque of 30 %, 15 %, and 27 %, respectively.

Conclusion

Comparison of the treatment of intertrochanteric fractures with InterTAN and PFNA internal fixation showed that the InterTAN yielded improvement relative to the PFNA. InterTAN has a firmer and biomechanically superior performance and is therefore an ideal internal fixation method for treating intertrochanteric fractures. Additional research in osteopenic bone is necessary to comprehensively characterize the effects of the design enhancements of these two implants.     

股骨干合并同侧股骨颈骨折长髓内钉InterTAN与逆行髓内钉结合空心拉力螺钉内固定的对照研究

目的探讨长髓内钉InterTAN与逆行髓内钉结合空心拉力螺钉治疗股骨干合并同侧股骨颈骨折的特点,为临床应用提供参考。方法2006年1月-2010年9月应用两种内固定系统治疗股骨干合并同侧股骨颈骨折21例．长髓内钉InterTAN组12例,逆行髓内钉结合空心拉力螺钉组9例,其中术前漏诊1例。结果21例全部获得随访．随访时间11-26个月,平均（17．3±0．6）个月。长髓内钉InterTAN组骨折愈合时间：股骨颈平均13．8周,股骨干平均16周,Harris评分标准优良率为83．33％。逆行髓内钉结合空心拉力螺钉组骨折愈合时间：股骨颈平均14．1周,股骨干平均16．2周,Harris评分标准优良率为77．78％。结论长髓内钉InterTAN与逆行髓内钉结合空心拉力螺钉治疗效果相当,但髓内钉InterTAN具有操作简便、切12I小、软组织损伤小、并发症风险低等优点;而逆行髓内钉结合空心拉力螺钉可作为漏诊后简单易行的补救方法。     

髓内钉InterTAN和人工股骨头置换治疗老年不稳定股骨粗隆间骨折

目的比较InterTAN和人工股骨头置换治疗老年不稳定股骨粗隆间骨折的疗效。方法 35例老年不稳定股骨粗隆间骨折患者,17例用InterTAN治疗(InterTAN组),18例用骨水泥人工股骨头置换治疗(置换组)。对两组患者手术资料、术后卧床时间、骨折愈合时间及髋关节功能评分等数据,进行随访分析。结果 InterTAN组在切口长度、手术时间、术中出血量均优于置换组(P<0.05),术后卧床时间InterTAN组稍长(P<0.05),但骨折愈合时间无显著差异(P>0.05)。两组术后末次随访Harris评分无显著差异(P>0.05),置换组1例出现假体下沉。结论 InterTAN设计合理,尤其适用于骨质疏松老年不稳定的股骨粗隆间骨折。人工股骨头置换可以考虑,但应严格把握手术指征。     

两种髓内钉固定骨质疏松股骨粗隆间骨折的比较

[目的]比较股骨近端抗旋转髓内钉(proximal femoral nail anti-rotation,PFNA)与InterTAN髓内钉联合抗骨质疏松治疗骨质疏松性粗隆间骨折的临床疗效.[方法]回顾性分析2016年1月-2019年1月苏州大学第一附属医院骨科诊治的骨质疏松性股骨粗隆间骨折的老年患者的临床资料,共10...     

InterTAN钉结合3D打印治疗不稳定性股骨粗隆间骨折的临床疗效

目的观察InterTAN钉结合3D打印技术治疗不稳定性股骨粗隆间骨折的临床疗效。方法回顾性分析2017年1月至2018年12月蚌埠医学院第二附属医院40例确诊为不稳定性股骨粗隆间骨折患者的临床资料,根据治疗方法的不同,分为A组与B组,每组20例。A组采用InterTAN钉结合3D打印治疗,B组采用股骨近端防旋髓内钉(PFNA)治疗。观察比较两组患者术中出血量、手术时间、术后下地时间、骨折愈合时间、术后相关并发症及术后第3天Harris评分的差异。结果两组患者手术时间、术中出血量及骨折愈合时间进行比较,差异无统计学意义(P>0.05);A组患者平均术后下地时间为(14.12±3.43)d, B组为(21.42±2.81) d,差异有统计学意义(P<0.05);A组患者术后相关并发症的发生率为5.00%,低于B组,差异有统计学意义(P<0.05);术后第3天,A组患者Harris评分为(89.08±5.37)分,高于B组,差异有统计学意义(P<0.05),两组患者术前与术后第3天Harris评分的差值进行比较,差异有统计学意义(P<0.05)。结论 Inter...     

InterTAN髓内钉与动力髋螺钉治疗股骨转子间骨折疗效比较

目的 比较InterTAN髓内钉(IT)与动力髋螺钉(DHS)治疗股骨转子间骨折的疗效.方法 选择行手术治疗的股骨转子间骨折患者56例,根据手术方式不同分为IT组21例和DHS组35例,比较两组术中情况(手术时间、术中出血量、切口长度、住院时间)、术后并发症(伤口感染、下肢深静脉血栓、褥疮、尿路感染、肺炎)和骨折愈合情况(骨折愈合时间、股骨颈短缩、髋内翻及髋关节Harris评分).结果 IT组手术时间、术中出血量、切口长度和住院时间均明显优于DHS组[(62.16±15.26) min比(85.78±19.50) min、(237.73±108.51) ml比(490.87±127.90) ml、(10.20±2.02) cm比(19.83±2.98) cm和(10.23±5.52)d比(15.58±5.32)d,P＜ 0.01],两组术后并发症比较差异无统计学意义(P＞0.05).IT组股骨颈短缩和髋内翻发生率明显少于DHS组[9.52％(2/21)比28.57％(10/35)和14.29％(3/21)比31.43％(11/35),P＜0.01],在骨折愈合时间及髋关节Harris评分方面两组比较差异无统计学意义(P＞0.05).结论 与DHS相比,IT的应用范围更广,手术时间明显缩短,且固定可靠,更适用于治疗股骨转子间骨折.