Long versus short proximal femoral nail antirotation in treatment of intertrochanteric fractures / 中国组织工程研究

ABSTRACT

BACKGROUND:There are few clinical control ed trials about the clinical effects in patients with pertrochanteric femur fractures after treatment with short or long proximal femoral nail antirotation. OBJECTIVE:To compare the clinical outcomes in patients with AO/ASIF-A1/2 pertrochanteric femur fractures after treatment with short or long proximal femoral nail antirotation. METHODS:A total of 98 patients with AO/ASIF-A1/2 pertrochanteric femur fractures were treated by proximal femoral nail antirotation. They were divided into two groups according to the type of proximal femoral nail antirotationshort nail group (n=50) and long nail group (n=48). The operative time, blood loss, and hospital stay were recorded in both groups. In fol ow-up, fracture healing time, imaging and clinical complications were evaluated. In the final fol ow-up, Harris hip score was used to evaluate functional recovery. RESULTS AND CONCLUSION:Compared with the short nail group, operative time was shorter and blood loss was less in the long nail group (P0.05). Average fol ow-up periods were respectively (15.8±6.4) months and (16.2±5.7) months in the long nail and short nail groups.“Cutting-out”or infection occurred in five patients in the long nail group and three in the short nail group. Besides above-mentioned patients, the remaining patients in the two groups achieved fracture healing. No significant difference in average fracture healing time was detected between groups (P=0.588). In the final fol ow-up, no significant difference in Harris hip score was detectable in the two groups (P=0.204). The incidence rates of total postoperative complications in the long and short nail groups were 31.2%and 16.0%, respectively (P=0.075). Results suggested that no differences in the union and complication rates between the two groups were identified, suggesting that long nails offer no advantage compared with short nails for stabilizing AO/ASIF-A1/A2 pertrochanteric femur fractures.