Comparison of the effect of proximal femoral nail anti-rotation and dynamic hip screws in intertrochanteric fracture in elderly patients with osteoporosis_West China Medical Journal

Authors：

HE Xin , HUANG Qiang , LI Zhengjiang , LI Yongkui ,  GU Qishan

Department of Orthopaedics, the Fifth People’s Hospital of Chengdu, Chengdu, Sichuan 611130, P. R. China;

Corresponding?author：

GU Qishan, Email: CDWYYGK@foxmail.com

Keywords：

Intertrochanteric fracture; Proximal femoral nail anti-rotation; Osteoporosis

DOI：

10.7507/1002-0179.201508064

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the effect of proximal femoral nail anti-rotation (PFNA) and dynamic hip screw (DHS) in the treatment of intertrochanteric fracture in elderly patients with osteoporosis. Methods A total of 72 elderly patients with intertrochanteric fractures were enrolled between December 2011 and December 2014. According to the different surgical methods, the patients were divided into PFNA group (38 cases) and DHS group (34 cases). The operation time, perioperative blood loss, postoperative weight-bearing time, Harris score were compared between the two groups. Results All cases were followed up for 5–24 months (mean, 13.5 months). The operation time in PFNA group was shorter than that in DHS group [(40.25±24.23) vs. (72.65±34.65) minutes], the perioperative blood loss in PFNA group was less than that in DHS group [(136±56) vs. (256±102) mL], the postoperative weight-bearing time in PFNA group was earlier than that in DHS group [(5.24±4.52) vs. (15.69±6.78) days], and the Harris score in PFNA group was higher than that in DHS group (80.23±10.26 vs. 54.75±12.37) ; the differences above were all statistically significant (P<0.05). Conclusion Elderly patients with intertrochanteric fracture and osteoporosis treated with PFNA have shorter operation time, less wounds, better hip function, and earlier weight-bearing than the patients treated with DHS; the surgical method can improve the patient′ life quality.

Citation： HE Xin, HUANG Qiang, LI Zhengjiang, LI Yongkui, GU Qishan. Comparison of the effect of proximal femoral nail anti-rotation and dynamic hip screws in intertrochanteric fracture in elderly patients with osteoporosis. West China Medical Journal, 2017, 32(8): 1208-1211. doi: 10.7507/1002-0179.201508064 Copy

1.	Xu YZ, Geng DC, Mao HQ, et al. A comparison of the proximal femoral nail antirotation device and dynamic hip screw in the treatment of unstable pertrochanteric fracture. J Int Med Res, 2010, 38(4): 1266-1275.
2.	Ak?nc? O, Akal?n Y, Reiso?lu A, et al. Comparison of long-term results of dynamic hip screw and AO 130 degrees blade plate in adult trochanteric region fractures. Acta Orthop Traumatol Turc, 2010, 44(6): 443-451.
3.	李正疆, 張焱, 顧琪珊, 等. 成都市溫江區老年骨質疏松性骨折的流行病學調查. 四川醫學, 2015, 2(36): 156-157.
4.	劉忠厚, 楊定焯, 朱漢民, 等. 中國人骨質疏松癥建議診斷標準(第二稿). 中國骨質疏松雜志, 2000, 1(6): 1-3.
5.	Hwang JH, Oh JK, Han SH, et al. Mismatch between PFNa and medullary canal causing difficulty in nailing of the pertrochanteric fractures. Arch Orthop Trauma Surg, 2008, 128(12): 1443-1446.
6.	石永新, 李富琴, 譚文甫, 等. 股骨近端防旋髓內釘與鎖定加壓接骨板治療老年外側壁薄弱型股骨粗隆間骨折療效比較. 中國修復重建外科雜志, 2014, 28(10): 1199-1203.
7.	Konstantinidis L, Papaioannou C, Mehlhorn A, et al. Salvage procedures for trochanteric femoral fractures after internal fixation failure: biomechanical comparison of a plate fixator and the dynamic condylar screw. Proc Inst Mech Eng H, 2011, 225(7): 710-717.
8.	蘇文珍, 林永杰, 孫立民, 等. PFNA、DHS 與 FHR 治療老年股骨粗隆間骨折的療效比較. 醫學與哲學, 2014, 35(497): 26-29.
9.	王愉思, 何畔, 魏磊平, 等. 人工股骨頭置換與 DHS 內固定治療高齡不穩定股骨粗隆間骨折的隨機對照研究. 中國骨與關節損傷雜志, 2010, 25(10): 869-872.
10.	Shen L, Zhang Y, Shen Y, et al. Antirotation proximal femoral nail versus dynamic hip screw for intertrochanteric fractures: a meta-analysis of randomized controlled studies. Orthop Traumatol Surg Res, 2013, 99(4): 377-383.
11.	Curtis MJ, Jinnah RH, Wilson V, et al. Proximal femoral fractures: a biomechanical study to compare intramedullary and extramedullary fixation. Injury, 1994, 25(2): 99-104.
12.	Sahin EK, Imerci A, K?n?k H, et al. Comparison of proximal femoral nail antirotation (PFNA) with AO dynamic condylar screws (DCS) for the treatment for unstable peritrochanteric femoral fractures. Eur J Orthop Surg Traumatol, 2014, 24(3): 347-352.
13.	武斌, 梁杰, 杜遠立, 等. 髖關節置換與動力髖螺釘內固定治療高齡股骨粗隆間骨折療效觀察. 中國矯形外科雜志, 2012, 20(20): 1900-1902.
14.	韋旭明, 孫振中, 宋驍軍. 經皮加壓鋼板與股骨近端防旋髓內釘治療外側壁危險型股骨粗隆間骨折的病例對照研究. 中國骨傷, 2013, 26(12): 981-984.
15.	朱漢民. 雙膦酸鹽和骨質疏松. 中國實用內科雜志, 2011, 31(7): 517-520.
16.	何成奇, 熊恩富, 熊素芳, 等. 骨質疏松癥的運動防治. 國外醫學: 物理醫學與康復學分冊, 2000, 20(1): 7-9.

1. Xu YZ, Geng DC, Mao HQ, et al. A comparison of the proximal femoral nail antirotation device and dynamic hip screw in the treatment of unstable pertrochanteric fracture. J Int Med Res, 2010, 38(4): 1266-1275.
2. Ak?nc? O, Akal?n Y, Reiso?lu A, et al. Comparison of long-term results of dynamic hip screw and AO 130 degrees blade plate in adult trochanteric region fractures. Acta Orthop Traumatol Turc, 2010, 44(6): 443-451.
3. 李正疆, 張焱, 顧琪珊, 等. 成都市溫江區老年骨質疏松性骨折的流行病學調查. 四川醫學, 2015, 2(36): 156-157.
4. 劉忠厚, 楊定焯, 朱漢民, 等. 中國人骨質疏松癥建議診斷標準(第二稿). 中國骨質疏松雜志, 2000, 1(6): 1-3.
5. Hwang JH, Oh JK, Han SH, et al. Mismatch between PFNa and medullary canal causing difficulty in nailing of the pertrochanteric fractures. Arch Orthop Trauma Surg, 2008, 128(12): 1443-1446.
6. 石永新, 李富琴, 譚文甫, 等. 股骨近端防旋髓內釘與鎖定加壓接骨板治療老年外側壁薄弱型股骨粗隆間骨折療效比較. 中國修復重建外科雜志, 2014, 28(10): 1199-1203.
7. Konstantinidis L, Papaioannou C, Mehlhorn A, et al. Salvage procedures for trochanteric femoral fractures after internal fixation failure: biomechanical comparison of a plate fixator and the dynamic condylar screw. Proc Inst Mech Eng H, 2011, 225(7): 710-717.
8. 蘇文珍, 林永杰, 孫立民, 等. PFNA、DHS 與 FHR 治療老年股骨粗隆間骨折的療效比較. 醫學與哲學, 2014, 35(497): 26-29.
9. 王愉思, 何畔, 魏磊平, 等. 人工股骨頭置換與 DHS 內固定治療高齡不穩定股骨粗隆間骨折的隨機對照研究. 中國骨與關節損傷雜志, 2010, 25(10): 869-872.
10. Shen L, Zhang Y, Shen Y, et al. Antirotation proximal femoral nail versus dynamic hip screw for intertrochanteric fractures: a meta-analysis of randomized controlled studies. Orthop Traumatol Surg Res, 2013, 99(4): 377-383.
11. Curtis MJ, Jinnah RH, Wilson V, et al. Proximal femoral fractures: a biomechanical study to compare intramedullary and extramedullary fixation. Injury, 1994, 25(2): 99-104.
12. Sahin EK, Imerci A, K?n?k H, et al. Comparison of proximal femoral nail antirotation (PFNA) with AO dynamic condylar screws (DCS) for the treatment for unstable peritrochanteric femoral fractures. Eur J Orthop Surg Traumatol, 2014, 24(3): 347-352.
13. 武斌, 梁杰, 杜遠立, 等. 髖關節置換與動力髖螺釘內固定治療高齡股骨粗隆間骨折療效觀察. 中國矯形外科雜志, 2012, 20(20): 1900-1902.
14. 韋旭明, 孫振中, 宋驍軍. 經皮加壓鋼板與股骨近端防旋髓內釘治療外側壁危險型股骨粗隆間骨折的病例對照研究. 中國骨傷, 2013, 26(12): 981-984.
15. 朱漢民. 雙膦酸鹽和骨質疏松. 中國實用內科雜志, 2011, 31(7): 517-520.
16. 何成奇, 熊恩富, 熊素芳, 等. 骨質疏松癥的運動防治. 國外醫學: 物理醫學與康復學分冊, 2000, 20(1): 7-9.

West China Medical Journal

Comparison of the effect of proximal femoral nail anti-rotation and dynamic hip screws in intertrochanteric fracture in elderly patients with osteoporosis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content