Efficacies of proximal femoral nail anti-rotation internal fixation in different body positions on elderly unstable femoral intertrochanteric fractures

ZHAO Ling-yan; ZHAO Hong-bo; YANG Dong-hai; LIANG Hui; CAO Cheng-ming; LIU Xiao-ning

doi:10.11659/jjssx.03E023124

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Efficacies of proximal femoral nail anti-rotation internal fixation in different body positions on elderly unstable femoral intertrochanteric fractures

Clinical Research | 更新时间：2024-04-01

- Efficacies of proximal femoral nail anti-rotation internal fixation in different body positions on elderly unstable femoral intertrochanteric fractures
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 3, Pages: 239-242(2024)
- 作者机构：
  
  华北医疗健康集团峰峰总医院邯郸院区骨科，河北邯郸 056001
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.03E023124
  CLC： R687.3
- Published：25 March 2024，
  
  Received：20 March 2023，
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赵凌燕,赵洪波,杨东海等.不同体位股骨近端防旋髓内钉内固定治疗老年不稳定型股骨粗隆间骨折的疗效[J].局解手术学杂志,2024,33(03):239-242.

ZHAO Ling-yan,ZHAO Hong-bo,YANG Dong-hai,et al.Efficacies of proximal femoral nail anti-rotation internal fixation in different body positions on elderly unstable femoral intertrochanteric fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(03):239-242.
赵凌燕,赵洪波,杨东海等.不同体位股骨近端防旋髓内钉内固定治疗老年不稳定型股骨粗隆间骨折的疗效[J].局解手术学杂志,2024,33(03):239-242. DOI： 10.11659/jjssx.03E023124.

ZHAO Ling-yan,ZHAO Hong-bo,YANG Dong-hai,et al.Efficacies of proximal femoral nail anti-rotation internal fixation in different body positions on elderly unstable femoral intertrochanteric fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(03):239-242. DOI： 10.11659/jjssx.03E023124.

摘要

目的

探讨牵引床仰卧位及非牵引床侧卧位下行股骨近端防旋髓内钉（PFNA）内固定治疗老年不稳定型股骨粗隆间骨折的疗效。

方法

回顾性分析我院采用PFNA内固定治疗的不稳定型股骨粗隆间骨折患者的临床资料，将在牵引床仰卧位下治疗的41例患者纳入仰卧位组，将采取非牵引床侧卧位治疗的55例患者纳入侧卧位组。分析2组患者围术期相关指标情况、手术复位情况、髋关节Harris评分及并发症发生情况。

结果

侧卧位组患者手术时间、切口长度短于仰卧位组，术中出血量、透视次数少于仰卧位组，差异有统计学意义（

0.05）。2组患者麻醉方式、输血情况、住院时间比较差异无统计学意义（

0.05）。2组患者术后并发症发生情况比较，差异无统计学意义（

0.05）。2组患者颈干角、尖顶距、髋关节Harris评分比较差异无统计学意义（

0.05）。

结论

牵引床仰卧位及非牵引床侧卧位下行PFNA内固定治疗老年股骨不稳定型粗隆间骨折的疗效相当，但非牵引床侧卧位在缩短手术时间、降低术中出血量、减少放射暴露方面更具优势。

Abstract

Objective

To investigate the efficacies of proximal femoral nail anti-rotation （PFNA） internal fixation in traction bed supine position and non-traction bed lateral position in the treatment of elderly unstable femoral intertrochanteric fractures.

Methods

The clinical data of patients with unstable femoral intertrochanteric fractures treated with PFNA internal fixation in our hospital were retrospectively analyzed， 41 patients received treatment in traction bed supine position were included in the supine position group， and 55 patients treated received treatment in non-traction bed lateral position were included in the lateral position group. The perioperative related indicators， surgical reduction， hip Harris score， and incidence of complications in the two groups were analyzed.

Results

The operation time and incision length of patients in the lateral position group were shorter than those in the supine position group， and the intraoperative blood loss and fluoroscopy times were less than those in the supine position group， with statistically significant differences （

0.05）. There was no significant difference in the anesthesia mode， blood transfusion or hospital stay of patients between the two groups （

0.05）. There was no significant difference in the incidence of postoperative complications of patients between the two groups （

0.05）. There was no significant difference in neck-shaft angle， tip-apex distance or hip Harris score of patients between the two groups （

0.05）.

Conclusion

PFNA internal fixation in traction bed supine position and non-traction bed lateral position have the same effect in the treatment of elderly unstable femoral intertrochanteric fractures， while the non-traction bed lateral position for treatment has more advantages in shortening operation time， decreasing intraoperative blood loss， and reducing radiation exposure.

关键词

股骨粗隆间骨折内固定股骨近端防旋髓内钉侧卧位仰卧位

Keywords

femoral intertrochanteric fracturesinternal fixationproximal femoral nail anti-rotationlateral positionsupine position

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