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Objective To compare the clinical efficacy between proximal femoral nail antirotation (PFNA) versus InterTAN nail in the treatment of senile patients with unstable femoral intertrochanteric fracture.Methods A retrospective study was conducted of the 164 senile patients with unstable femoral intertrochanteric fracture who had been treated at Department of Orthopedics,Shougang Hospital Affiliated to Peking University from January 2013 to March 2018.InterTAN nailing was performed in 93 of them,including 30 men and 63 women with an age of 84.5 ± 2.4 years;by the AO classification,there were 53 cases of type 3 1-A2.2,28 cases of type 3 1-A2.3 and 12 cases of type 3 1-A3.PENA fixation was performed in the other 71 patients,including 19 men and 52 women with an age of 83.8 ±2.3 years;by the AO classification,there were 41 cases of type 31-A2.2,22 cases of type 31-A2.3 and 8 cases of type 31-A3.The 2 groups were compared in terms of weight-bearing time,thigh pain,hip function,imaging complications and postoperative quality of life.Results The 2 groups were comparable because there were no significant differences between them in preoperative general data (P ＞ 0.05).In the InterTAN nail group,the incidence of imaging complications [5.4％ (5/93)] was significantly lower than in the PFNA group [18.3％ (13/71)],the weight-bearing time (60.0 ± 13.6 d) significantly shorter than in the PFNA group (65.8 ±.11.0 d),and the incidence of thigh pain [3.2％ (3/93)] significantly lower than in the PFNA group [12.7％ (9/71)] (all P ＜0.05).Of this series,153 patients obtained an average follow-up of 39 months (from 12 to 75 months).At the last follow-ups,the Harris scores in the InterTAN nail group (78.3 ± 12.2) were significantly higher than in the PENA group (73.6 ± 1 1.3) (P ＜ O.05).The InterTAN nail group scored significantly higher in physical functioning (68.6 ± 15.4),general health perceptions (78.2 ± 10.3),vitality (74.0 ± 12.6) and mental health (80.6 ±9.9) in the 36-item short form health survey (SF-36) than the PFNA groups did (64.1±9.9,74.9±9.0,69.9±10.9 and77.4±8.8) (all P ＜0.05).Conclusions Both internal fixation procedures are able to heal the fracture and restore the hip function in the senile patients with unstable femoral intertrochanteric fracture.However,InterTAN nail may have the advantages of earlier weight-bearing,lower incidence of varus deformity and better recovery of postoperative quality of life.
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Objective@#To compare the clinical efficacy between proximal femoral nail antirotation (PFNA) versus InterTAN nail in the treatment of senile patients with unstable femoral intertrochanteric fracture.@*Methods@#A retrospective study was conducted of the 164 senile patients with unstable femoral intertrochanteric fracture who had been treated at Department of Orthopedics, Shougang Hospital Affiliated to Peking University from January 2013 to March 2018. InterTAN nailing was performed in 93 of them, including 30 men and 63 women with an age of 84.5±2.4 years; by the AO classification, there were 53 cases of type 31-A2.2, 28 cases of type 31-A2.3 and 12 cases of type 31-A3. PENA fixation was performed in the other 71 patients, including 19 men and 52 women with an age of 83.8±2.3 years; by the AO classification, there were 41 cases of type 31-A2.2, 22 cases of type 31-A2.3 and 8 cases of type 31-A3. The 2 groups were compared in terms of weight-bearing time, thigh pain, hip function, imaging complications and postoperative quality of life.@*Results@#The 2 groups were comparable because there were no significant differences between them in preoperative general data (P>0.05). In the InterTAN nail group, the incidence of imaging complications [5.4%(5/93)] was significantly lower than in the PFNA group [18.3%(13/71)], the weight-bearing time (60.0±13.6 d) significantly shorter than in the PFNA group (65.8±11.0 d), and the incidence of thigh pain [3.2%(3/93)] significantly lower than in the PFNA group [12.7%(9/71)] (all P< 0.05). Of this series, 153 patients obtained an average follow-up of 39 months (from 12 to 75 months). At the last follow-ups, the Harris scores in the InterTAN nail group (78.3±12.2) were significantly higher than in the PENA group (73.6±11.3) (P<0.05). The InterTAN nail group scored significantly higher in physical functioning (68.6±15.4), general health perceptions (78.2±10.3), vitality (74.0±12.6) and mental health (80.6±9.9) in the 36-item short form health survey (SF-36) than the PFNA groups did (64.1±9.9, 74.9±9.0, 69.9±10.9 and 77.4±8.8) (all P<0.05).@*Conclusions@#Both internal fixation procedures are able to heal the fracture and restore the hip function in the senile patients with unstable femoral intertrochanteric fracture. However, InterTAN nail may have the advantages of earlier weight-bearing, lower incidence of varus deformity and better recovery of postoperative quality of life.
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BACKGROUND:The conservative treatment of humeral fracture is difficult to achieve a good reduction. Minimaly invasive percutaneous plate fixation has been widely used, and has good repair results, but the specific mechanism of action is not clear. OBJECTIVE:To compare the repair effect of different fixation methods on proximal humerus fractures. METHODS: From August 2011 to October 2014, we selected 96 patients with proximal humerus fractures from the Shougang Hospital of Peking University. These patients were equaly divided into two groups according to the principle of random draw. Patients in the control group were treated with open reduction and conventional surgery fixation. Patients in the treatment group received minimaly invasive percutaneous plate fixation. Operation time, intraoperative blood loss, incision length and postoperative hospital stay were recorded in both groups. At 8 weeks after treatment, patients received radiography to identify the reduction. Range of motion of the shoulder joint was scored. Within 8 weeks after treatment, the occurrence of complications was observed and compared in both groups. RESULTS AND CONCLUSION:Intraoperative blood loss, incision length and postoperative hospital stay were significantly less in the treatment group than in the control group (P 0.05). At 8 weeks after treatment, the excelent and good rate of reduction was significantly higher in the treatment group than in the control group (98%, 81%,P < 0.05). Flexion, abduction, external rotation and internal rotation scores were significantly higher in the treatment group than in the control group (P < 0.05). Bone compartment syndrome, vascular injury, infection and bleeding were significantly lower in the treatment group than in the control group (P < 0.05). These findings confirm that compared with open reduction and internal fixation, minimaly invasive percutaneous plate fixation of proximal humerus fractures has less impact on the body, can promote reduction of the fracture, has few complications, and contributes to the recovery of shoulder function.
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Objective To retrospectively report 30 cases of distal femoral fractures treated with retrograde intramedullary interlocking naill( GSH nail). Methods From February 1999 to December 2002, 30 cases of distal femoral fractures were treated with GSH nails.According to AO/ASIF classification system, there were 11 cases of type A1, 7 A2, 3 A3, 5 C1, 3 C2 ,and 1 C3 .The follow up period ranged from 6 to 54 months. Results The average time for bone healing was 16 weeks. According to Neer s knee rating scale, there were 21 excellent cases and 5 good; the excellent and good rate was 86.6% . Conclusion It's a good method to treat type A& C (AO/ASIF) distal femoral fractures with GSH nail.