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...

Comparison of two intramedullary nails for osteoporotic intertrochanteric fractures of the femur

[Objective]To compare the clinical efficacy of proximal femoral nail anti-rotation(PFNA)versus InterTAN intramedullary nail combined with anti-osteoporosis therapy for osteoporotic intertrochanteric fractures of the femur.[Methods]A total of 102 elderly patients who underwent surgical treatment for osteoporotic intertrochanteric fracture of the femur in our hospital from January 2016 to January 2019 were included in this study.According to the results of preoperative doctor-patient communication,53 patients received PFNA fixation,while the other 49 patients received InterTAN fixation.The Perioperative,follow-up and imaging documents were compared between the two groups.[Results]All patients in both groups had surgical procedures performed successfully.The InterTAN group proved significantly superior to the PFNA group in terms of operation time,incision length and intraoperative blood loss(P<0.05).All patients were fol-lowed up for 12?32 months,with an average of(22.52±6.41)months.InterTAN group resumed walking and full weight bearing activity sig-niflcantly earlier than PFNA group(P<0.05).The hip extension-flexion range of motion(ROM),internal-external rotation ROM,and Harris score significantly increased postoperatively compared with those preoperatively in both groups(P<0.05),which in the InterTAN group were significantly better than those in the PFNA group at 6 months and the latest follow-up(P<0.05).With respect to imaging evaluation,the Inter TAN group got significantly higher rate of proper fracture reduction than the PFNA group(P<0.05).By the time of the latest follow-up,the fracture healing was achieved in all patients of both groups without nonunion.At the latest follow-up,the InterTAN group was significantly superior to the PFNA group in terms of femoral shortening and femoral neck-shaft angle(P<0.05).[Conclusion]For osteoporotic intertrochanteric fractures of the femur,the InterTAN used as internal fixation is considerably better than the PFNA.