Treatment of subtrochanteric femoral fractures with proximal femoral nail antirotation

doi:10.3969/j.issn.2095-4344.2013.48.012

Abstract

Abstract:

BACKGROUND: Biomechanical examinations have shown that intramedullary devices are stronger and have the advantages of fixation stability, which can reduce the risk of malunion and fixation failure. The choice of fixation implant is demanded and controversy in the fixation of subtrochanteric femoral fractures.
OBJECTIVE: To evaluate the therapeutic effects of proximal femoral nail antirotation on the treatment of subtrochanteric femoral fractures.
METHODS: Between June 2006 and November 2011, 17 patients with traumatic subtrochanteric fractures of the femur who received proximal femoral nail antirotation were selected from First Affiliated Hospital of Soochow University and retrospectively analyzed. There were nine cases of Seinsheimer type Ⅴ, two cases of Seinsheimer ⅡB, one case of Seinsheimer ⅢB and four cases of Seinsheimer Ⅳ, and one case of Seinsheimer type Ⅴ involving ipsilateral femoral shaft. Injury cause: high-energy injuries in16 cases, and low-energy damage in one case. Operation time, intraoperative bleeding, fracture healing time and limb functional recovery were recorded.
RESULTS AND CONCLUSION: All the patients were followed for 8-24 months, 16.2 months on average. Postoperative X-ray films showed that the fracture healing time was averagely 5.4 months. All of the fractures were recovered well that subtrochanteric fractures, intertrochanteric fractures and femoral shaft fractures were all healed. There was no fracture displacement, internal fixation loosening and varus deformity. Only one case showed difficulties in nail insertion. Excellence rate of Harris hip functional scores was 88.2% postoperatively. Proximal femoral nail antirotation is a reasonable design, and the helical blade can resist the rotation and stabilize the angle. The proximal femoral nail antirotation has better effects, which is an ideal internal fixation for subtrochanteric femoral fractures.

Key words: femur, fracture healing, fracture fixation, femoral fractures, bone marrow

CLC Number:

R318

Zhao Hai-sheng, Xu Yao-zeng, Wang Gui-xian, Li Rong-qun . Treatment of subtrochanteric femoral fractures with proximal femoral nail antirotation[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(48): 8368-8373.

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