Clinical application of fast locator in proximal femoral nail antirotation for treating femoral intertrochanter fractures / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical application of fast locator in proximal femoral nail antirotation (PFNA) for treating femoral intertrochanter fractures.Methods A retrospective case series study was conducted on the clinical data of 188 patients with femoral intertrochanteric fractures who were treated with closed reduction and PFNA from October 2010 to October 2014.There were 86 males and 102 females,with an average age of 69.5 years (range,55-96 years).Before operation,the patients were divided into two groups according to their will.Group A (98 cases) used the self-made locator to identify the entry point,and Group B (90 cases) used the routine incision operation.The operative preparation time,operation time,fluoroscopy frequency,incision length of major nail,intraoperative blood loss,Harris scores of hip joint function at 4 months after operation,and complications were recorded and compared between the two groups.Results Group A had a longer operative preparation time than Group B[(10.6 ±2.4) minutes vs.(2.5 ±0.9) minutes].However,the operation time [(26.0 ±5.5) minutes vs.(56.6 ± 9.4) minutes],total operation time [(36.6 ± 6.6) minutes vs.(59.6 ± 9.9) minutes],fluoroscopy frequency [(18.9 ± 5.1) times vs.(31.2 ± 9.1) times],blood loss [(50.5 ± 3.7) ml vs.(220.5 ± 2.7) ml] and incision length of major nail [(2.5 ± O.7) cm vs.(5.5 ± 1.7) cm] in Group A were all less than those in Group B (P ＜ 0.05).There was no significant difference in the excellent and good rate of Harris score at 4 months after operation between the two groups (97％ vs.97％) (P ＞0.05).Postoperative incision infection,hypostatic pneumonia,and deep vein thrombosis occurred in some patients.No significant difference in the incidence rates of complications in two groups (14％ vs.10％) was found (P ＞ 0.05).Conclusion Femoral nail needle point locator can quickly identify the entry point,improve the nail placement accuracy and reduce surgical trauma as well as shorten operation time,and hence is worthy of clinical application in the treatment of femoral intertrochanteric fractures.