Effectiveness of proximal femur bionic nail for intertrochanteric fracture in the elderly_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Dongsong ¹ , WANG Qiong ¹ , LUAN Zhonghao ² , LING Jiansheng ¹ , CHEN Peng ¹ , CHEN Xudong ¹ , YUAN Dongtao ¹ , ZHEN Xiangzhou ¹ ,  WANG Junqiang ³

1. Department of Orthopedics, the Second Affiliated Hospital of Luohe Medical College, Luohe Henan, 462300, P. R. China;
2. Department of Information, the Second Affiliated Hospital of Luohe Medical College, Luohe Henan, 462300, P. R. China;
3. Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China;

Corresponding?author：

WANG Junqiang, Email: drw-jq1997@163.com

Keywords：

Intertrochanteric fracture; proximal femoral nail antirotation; proximal femur bionic nail; internal fixation; the elderly

DOI：

10.7507/1002-1892.202305083

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Objective To evaluate effectiveness of proximal femur bionic nail (PFBN) in treatment of intertrochanteric fractures in the elderly compared to the proximal femoral nail antirotation (PFNA). Methods A retrospective analysis was made on 48 geriatric patients with intertrochanteric fractures, who met the selection criteria and were admitted between January 2020 and December 2022. Among them, 24 cases were treated with PFBN fixation after fracture reduction (PFBN group), and 24 cases were treated with PFNA fixation (PFNA group). There was no significant difference in baseline data such as age, gender, cause of injury, side and type of fracture, time from injury to operation, and preoperative mobility score, American Society of Anesthesiologists (ASA) score, Alzheimer’s disease degree scoring, self-care ability score, osteoporosis degree (T value), and combined medical diseases between the two groups (P>0.05). The operation time, intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, occurrence of complications, weight-bearing time after operation, and postoperative visual analogue scale (VAS) score, walking ability score, mobility score, self-care ability score were recorded and compared between the two groups. And the radiographic assessment of fracture reduction quality and postoperative stability, and fracture healing time were recorded. Results The operations in both groups were successfully completed. All patients were followed up 6-15 months with an average time of 9.8 months in PFBN group and 9.6 months in PFNA group. The operation time was significantly longer in PFBN group than in PFNA group (P<0.05), but there was no significant difference in intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, change in activity ability score, and change in self-care ability score between the two groups (P>0.05). The weight-bearing time after operation was significantly shorter in PFBN group than in PFNA group (P<0.05), and the postoperative VAS score and walking ability score were significantly better in PFBN group than in PFNA group (P<0.05). Radiographic assessment showed no significant difference in fracture reduction scores and postoperative stability scores between the two groups (P>0.05). All fractures healed and there was no significant difference in fracture healing time between the two groups (P>0.05). The incidence of complications was significantly lower in PFBN group (16.7%, 4/24) than in PFNA group (45.8%, 11/24) (P<0.05). Conclusion Compared with PFNA, PFBN in the treatment of elderly intertrochanteric fractures can effectively relieve postoperative pain, shorten bed time, reduce the risk of complications, and facilitate the recovery of patients’ hip joint function and walking ability.

Citation： YANG Dongsong, WANG Qiong, LUAN Zhonghao, LING Jiansheng, CHEN Peng, CHEN Xudong, YUAN Dongtao, ZHEN Xiangzhou, WANG Junqiang. Effectiveness of proximal femur bionic nail for intertrochanteric fracture in the elderly. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(10): 1198-1204. doi: 10.7507/1002-1892.202305083 Copy

1.	胡孫君, 杜守超, 熊文峰, 等. 股骨近端防旋髓內釘內固定治療高位股骨轉子間骨折. 中國修復重建外科雜志, 2021, 35(3): 307-311.
2.	中國脆性骨折聯盟, 中國老年醫學學會骨與關節分會創傷骨科學術工作委員會, 白求恩·骨科加速康復聯盟, 等. 老年股骨轉子間骨折診療指南. 中華創傷骨科雜志, 2020, 22(2): 93-99.
3.	Li J, Yin P, Zhang L, et al. Medial anatomical buttress plate in treating displaced femoral neck fracture a finite element analysis. Injury, 2019, 50(11): 1895-1900.
4.	張世民. 老年髖部轉子間骨折. 北京: 科學出版社, 2023: 518-519.
5.	朱燕賓, 陳偉, 葉丹丹, 等. 股骨近端N三角理論及股骨近端仿生髓內釘(PFNB)的設計理念. 中華老年骨科與康復電子雜志, 2021, 7(5): 257-259.
6.	張殿英. “杠桿-支點重建”理論重新認識股骨轉子間骨折內固定的過去和未來. 中華創傷骨科雜志, 2020, 22(10): 841-845.
7.	李祖濤, 殷劍, 肖偉, 等. 股骨近端仿生髓內釘與股骨近端防旋髓內釘固定治療老年股骨轉子間骨折的近期療效比較. 中華創傷骨科雜志, 2022, 24(6): 528-532.
8.	凌峰, 張偉, 常銳, 等. 股骨近端仿生髓內釘與股骨近端防旋髓內釘固定治療股骨轉子間骨折的近期療效比較. 中華創傷骨科雜志, 2023, 25(6): 544-548.
9.	Parker MJ, Palmer CR. A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg (Br), 1993, 75(5): 797-798.
10.	Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 1969, 9(3): 179-186.
11.	Sainsbury A, Seebass G, Bansal A, et al. Reliability of the Barthel Index when used with older people. Age Ageing, 2005, 34(3): 228-232.
12.	張世民, 張英琪, 李清, 等. 內側皮質正性支撐復位對老年股骨粗隆間骨折內固定效果的影響. 中國矯形外科雜志, 2014, 22(14): 1256-1261.
13.	林棟, 陳長青, 王升, 等. 股骨近端仿生髓內釘與股骨近端防旋髓內釘固定治療老年股骨轉子間骨折的早期療效比較. 中華創傷雜志, 2022, 38(11): 1027-1035.
14.	Wang Y, Chen W, Zhang L, et al. Finite element analysis of proximal femur bionic nail (PFBN) compared with proximal femoral nail antirotation and intertan in treatment of intertrochanteric fractures. Orthop Surg, 2022, 14(9): 2245-2255.
15.	朱燕賓, 丁凱, 李泳龍, 等. 三角支撐固定系統固定股骨轉子間骨折的生物力學有限元分析. 中華骨科雜志, 2021, 41(18): 1361-1366.
16.	張世民, 胡孫君, 杜守超,等. 股骨轉子間骨折一種新的綜合分類法. 中國修復重建外科雜志, 2022, 36(9): 1056-1063.

1. 胡孫君, 杜守超, 熊文峰, 等. 股骨近端防旋髓內釘內固定治療高位股骨轉子間骨折. 中國修復重建外科雜志, 2021, 35(3): 307-311.
2. 中國脆性骨折聯盟, 中國老年醫學學會骨與關節分會創傷骨科學術工作委員會, 白求恩·骨科加速康復聯盟, 等. 老年股骨轉子間骨折診療指南. 中華創傷骨科雜志, 2020, 22(2): 93-99.
3. Li J, Yin P, Zhang L, et al. Medial anatomical buttress plate in treating displaced femoral neck fracture a finite element analysis. Injury, 2019, 50(11): 1895-1900.
4. 張世民. 老年髖部轉子間骨折. 北京: 科學出版社, 2023: 518-519.
5. 朱燕賓, 陳偉, 葉丹丹, 等. 股骨近端N三角理論及股骨近端仿生髓內釘(PFNB)的設計理念. 中華老年骨科與康復電子雜志, 2021, 7(5): 257-259.
6. 張殿英. “杠桿-支點重建”理論重新認識股骨轉子間骨折內固定的過去和未來. 中華創傷骨科雜志, 2020, 22(10): 841-845.
7. 李祖濤, 殷劍, 肖偉, 等. 股骨近端仿生髓內釘與股骨近端防旋髓內釘固定治療老年股骨轉子間骨折的近期療效比較. 中華創傷骨科雜志, 2022, 24(6): 528-532.
8. 凌峰, 張偉, 常銳, 等. 股骨近端仿生髓內釘與股骨近端防旋髓內釘固定治療股骨轉子間骨折的近期療效比較. 中華創傷骨科雜志, 2023, 25(6): 544-548.
9. Parker MJ, Palmer CR. A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg (Br), 1993, 75(5): 797-798.
10. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 1969, 9(3): 179-186.
11. Sainsbury A, Seebass G, Bansal A, et al. Reliability of the Barthel Index when used with older people. Age Ageing, 2005, 34(3): 228-232.
12. 張世民, 張英琪, 李清, 等. 內側皮質正性支撐復位對老年股骨粗隆間骨折內固定效果的影響. 中國矯形外科雜志, 2014, 22(14): 1256-1261.
13. 林棟, 陳長青, 王升, 等. 股骨近端仿生髓內釘與股骨近端防旋髓內釘固定治療老年股骨轉子間骨折的早期療效比較. 中華創傷雜志, 2022, 38(11): 1027-1035.
14. Wang Y, Chen W, Zhang L, et al. Finite element analysis of proximal femur bionic nail (PFBN) compared with proximal femoral nail antirotation and intertan in treatment of intertrochanteric fractures. Orthop Surg, 2022, 14(9): 2245-2255.
15. 朱燕賓, 丁凱, 李泳龍, 等. 三角支撐固定系統固定股骨轉子間骨折的生物力學有限元分析. 中華骨科雜志, 2021, 41(18): 1361-1366.
16. 張世民, 胡孫君, 杜守超,等. 股骨轉子間骨折一種新的綜合分類法. 中國修復重建外科雜志, 2022, 36(9): 1056-1063.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of proximal femur bionic nail for intertrochanteric fracture in the elderly

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