Abstract:Objective To observe the efficacy of application of PFNA (Proximal Femoral Nail Antirotation) in treatment of intertrochanteric fractures. Methods Clinical data of 93 intertrochanteric fracture patients who had been treated in the hospital from June 2011 to June 2012 were retrospectively analyzed. Among all the patients, 40 cases were fixated internally through EPFN (Expandable Proximal Femoral Nail), which was the EPFN group; 53 cases were fixated internally through PFNA, which was the PFNA group. Both the methods were evaluated and compared from the perspective of surgical efficacy, postoperative pain, the incidence of improper operation and clinical efficacy. Results The mean healing time, postoperative activity time, Harris hip scores between two groups had no statistically significant differences (P>0.05). The PFNA group demonstrated its superiority over EPFN group in the aspects of average operation time, blood loss, improper operation and thigh pain. The statistically significant differences existed in the above indexes between the two groups (P<0.05). Conclusion PFNA proved its advantages in easy operation, convenience and proximity to the biomechanics of the proximal femur, which minimized the operation errors, reduced postoperative pain and was worthwhile to be promoted.
关吉昆,黄斌,张新颖,秦汉兴,韦智桂. 股骨近端抗旋髓内钉内固定治疗股骨转子下骨折的方法及疗效观察[J]. 中国医疗设备, 2015, 30(3): 94-97.
股骨转子下骨折是指股骨干峡部即成人股骨小转子至远端5 cm之间的骨折。流行病学调查显示,髋部骨折患者中约7%~34%累及转子下。这一区域应力集中,治疗比较棘手,如果内固定材料选择不当容易出现内固定失败、骨折延迟愈合或不愈合等并发症。股骨近端抗旋髓内钉(Proximal Femoral Nail Antirotation,PFNA)是近年来研制的一种新型抗旋髓内固定材料,是在股骨近端髓内钉(Proximal Femoral Nail,PFN)基础上研发的,具有以下优点:① PFNA内固定主钉跨越大段股骨,增加了髓内壁接触面积,使应力可平均分散;② PFNA缩短了其到股骨头中心的垂直距离,相对减少了断裂机会;③ PFNA主钉金属可承受较大负荷强度,使患者术后可早期进行功能锻炼和负重,有利于功能恢复。我院近年来应用PFNA治疗股骨转子周围骨折,疗效较好,报道如下。. Application and Efficacy Observation of PFNA in the Treatment of Intertrochanteric Fractures. China Medical Devices, 2015, 30(3): 94-97.