Percutaneous proximal femoral nail internal fixation for treatment of intertrochanteric fractures in the elderly with a report of 180 cases / 中国矫形外科杂志

ABSTRACT

[Objective]To analyze the clinical effect of intertrochanteric fractures treated with percutaneous proximal femoral nails(PFN).[Method]From January 2004 to May 2009,PFN using percutaneous technique was performed in 180 elderly patients of femoral intertrochanteric fractures(180 hips,80 males and 98 females),with mean age of 76 years(range from 57-99 years).According to Evans classification,12 cases were type Ⅰ,28 were type Ⅱ,62 were Ⅲa,20 were Ⅲb,49 were Ⅳ,9 were Ⅴ.Traction table and C-arm fluroscopic intensifier were used with close reduction and interlocking during the course of operation.[Result]One hundred and seventy two cases in 180 patients were followed up for 8 to 21 months with a mean of 13.5 months.Other 8 patients were lost to follow up after discharge.Of 172 patients followed up,166 cases' radiographs showed the callus during 6-8 weeks postoperatively,while they had a full range of hip motion as the original level.Partial weight bearing exercises were carried out since the 8th postoperative week.The time of clinical fracture healing was from 12 to 16 weeks,the rate of healing was 98.8%.In the function assessment of 172 patients the satisfactory rate reached to 87.8 percents.[Conclusion]Percutaneous proximal femoral nails is an ideal way for the treatment of intertrochanteric fractures in aged because of its simple procedure,minimal invasion,less fluoroscopy exposures,less complications,stable fixation,early fracture healing and satisfied functional outcomes.