Citation: | YANG Simeng, XIA Liangzheng, DENG Yinghu, ZHANG Tao, WANG Kang, LI Shenghua. Application of reconstructing physiological fulcrum in treatment of elderly patients with intertrochanteric fracture of femur[J]. Journal of Clinical Medicine in Practice, 2024, 28(24): 99-102, 109. DOI: 10.7619/jcmp.20242735 |
To observe effect of reconstructing physiological fulcrum in the treatment of elderly patients with intertrochanteric fracture of the femur.
Clinical materials of 40 elderly patients with osteoporotic intertrochanteric fracture of femur in the Tongling City People's Hospital from October 2020 to October 2022 were retrospectively analyzed. Among them, 20 patients treated with proximal femoral nail anti-rotation (PFNA) were assigned to the PFNA group, and 20 patients treated with proximal femoral bionic nail (PFBN) were assigned to the PFBN group. The operation time, intraoperative blood loss, length of hospital stay, postoperative rehabilitation, and incidence of complications were compared between the two groups.
The postoperative weight-bearing time in the PFBN group was (8.50±1.99) days, which was significantly shorter than (20.15±4.87) days in the PFNA group (P<0.05). There were no significant differences in operation time, intraoperative blood loss, length of hospital stay, fracture healing time, excellent and good rate of fracture reduction quality, and excellent and good rate of Harris score between the PFBN group and the PFNA group (P>0.05). During the follow-up period of 10 to 14 months, no patients had complications such as wound infection, bone nonunion, implant failure, or deep venous thrombosis.
Both PFBN and PFNA can effectively treat elderly patients with osteoporotic intertrochanteric fracture of femur. However, patients treated with PFBN can take bed-off activities earlier, which is beneficial for postoperative rehabilitation, and the reason may be related to the double triangular stable structure reconstructed by PFBN.
[1] |
张世民. 老年髋部转子间骨折[J]. 中国修复重建外科杂志, 2023, 37(3): 263-263.
|
[2] |
伍瓒, 徐永强, 范忠明, 等. 亚洲型股骨近端防旋髓内钉内固定治疗老年骨质疏松性股骨粗隆间骨折[J]. 中国骨与关节损伤杂志, 2021, 36(10): 1058-1060.
|
[3] |
NIEVES J W, BILEZIKIAN J P, LANE J M, et al. Fragility fractures of the hip and femur: incidence and patient characteristics[J]. Osteoporos Int, 2010, 21(3): 399-408. doi: 10.1007/s00198-009-0962-6
|
[4] |
薛鸣丰, 戴加平, 陈刚, 等. 后外侧入路解剖复位固定小转子在老年人股骨转子间骨折治疗中的应用[J]. 中华老年医学杂志, 2019, 38(9): 1028-1032.
|
[5] |
胡靖, 王林, 陈义, 等. 防旋股骨近端髓内钉治疗老年股骨粗隆间骨折的效果及对髋关节功能、生活质量和日常生活能力的影响[J]. 中国老年学杂志, 2022, 42(12): 2918-2920.
|
[6] |
蓝晖. 经小切口的股骨近端防旋髓内钉内固定对老年股骨粗隆间骨折的治疗效果[J]. 江西医药, 2023, 58(4): 464-467.
|
[7] |
番子加, 段恒都, 赵四强, 等. 组合式外固定架辅助闭合复位髓内钉内固定治疗老年股骨粗隆间骨折的临床体会[J]. 中国骨与关节损伤杂志, 2021, 36(2): 165-166.
|
[8] |
KIM S S, KIM H J, LEE C S. Clinical outcomes of PFNA-Ⅱ in the Asian intertrochanteric fracture patients: comparison of clinical results according to proximal nail protrusion[J]. Injury, 2020, 51(2): 361-366.
|
[9] |
黄啟云, 林红华. 股骨粗隆间骨折PFNA内固定术后内固定失效原因分析及预防措施[J]. 中国骨与关节损伤杂志, 2019, 34(12): 1283-1284.
|
[10] |
张英泽, 王海程, 陈伟. 股骨转子间骨折三角固定支撑手术的革新——来自生物力学研究的证据[J]. 中华创伤骨科杂志, 2021, 23(6): 461-466.
|
[11] |
中国脆性骨折联盟, 中国老年医学学会骨与关节分会创伤骨科学术工作委员会, 白求恩·骨科加速康复联盟, 等. 老年股骨转子间骨折诊疗指南[J]. 中华创伤骨科杂志, 2020, 22(2): 93-99.
|
[12] |
INUI T, WATANABE Y, SUZUKI T, et al. Anterior malreduction is associated with lag screw cutout after internal fixation of intertrochanteric fractures[J]. Clin Orthop Relat Res, 2024, 482(3): 536-545.
|
[13] |
HARRIS W H. 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.
|
[14] |
秦伟光. 老年股骨转子间骨折内固定治疗的研究进展[J]. 系统医学, 2021, 6(10): 195-198.
|
[15] |
宋宝东, 浦瑶瑶, 李贵宾, 等. 髓内钉固定与髋关节置换治疗老年股骨粗隆间骨折的效果比较[J]. 中国老年学杂志, 2023, 43(22): 5470-5472.
|
[16] |
李建涛, 张里程, 唐佩福. 股骨粗隆间骨折治疗理念与内固定器械的发展概述[J]. 中国修复重建外科杂志, 2019, 33(1): 1-7.
|
[17] |
张殿英. "杠杆-支点重建" 理论重新认识股骨转子间骨折内固定的过去和未来[J]. 中华创伤骨科杂志, 2020, 22(10): 841-845.
|
[18] |
朱燕宾, 陈伟, 叶丹丹, 等. 股骨近端N三角理论及股骨近端仿生髓内钉(PFBN)的设计理念展[J/CD]. 中华老年骨科与康复电子杂志, 2021, 7(5): 257-259.
|
[19] |
张殿英. 基于杠杆-支点平衡理论重新认识股骨近端外侧壁的作用[J]. 中华创伤杂志, 2022, 38(6): 481-486.
|
[20] |
张殿英. 基于杠杆支点重建理论股骨颈骨折内固定的治疗策略[J]. 中华骨科杂志, 2021, 41(12): 737-743.
|
[21] |
巩少康. 不同髓内固定方式应用于股骨粗隆间骨折的有限元分析[D]. 开封: 河南大学, 2023.
|