Total hip arthroplasty versus proximal femoral nail for intertrochanteric fractures

doi:10.3969/j.issn.2095-4344.2013.52.004

Abstract

Abstract:

BACKGROUND: Internal fixation has become the first choice for the treatment of intertrochanteric fractures. However, the methods and materials for internal fixation are various. Which one has the best clinical efficacy?
OBJECTIVE: To compare the effects of proximal femoral nail and total hip arthroplasty for the treatment of intertrochanteric fractures.
METHODS: A total of 46 patients with intertrochanteric fractures were voluntarily divided into two groups: proximal femoral nail and total hip arthroplasty. Operation time, intraoperative blood loss, and Harris scores were compared between the two groups, and X-ray examination was used for assessment of clinical efficacy in the two groups.
RESULTS AND CONCLUSION: Totally 46 patients were followed-up for 3 to 12 months. Fractures in all the patients were healed. As compared with the total hip arthroplasty group, in the proximal femoral nail group, approach incision was smaller, blood loss was higher, operation time and fracture healing time were longer, and Harris score was lower (P < 0.05). These findings indicate that the total hip arthroplasty is better than proximal femoral nail for intertrochanteric fractures, with less invasion and blood loss. However, the long-term effects need further studies.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: femoral neck fractures, arthroplasty, replacement, hip, hip prosthesis, internal fixators

CLC Number:

R318

Wang Ya-ping, Lu Tong. Total hip arthroplasty versus proximal femoral nail for intertrochanteric fractures[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(52): 8961-8966.

Figures/Tables 5

References

[1] Stevens JA, Anne Rudd R. Declining hip fracture rates in the United States. Age Ageing 2010;39(4):500-503.

[2] 张劲松.高龄不稳定型股骨转子间骨折行半髋关节置换的临床价值[J].中外医疗,2013,32(12):63-63.

[3] Shi B,Wang J,Yang H,et al.Emergency operation for the treatment of intertrochanteric fractures in elderly patients. Zhongguo Gu Shang. 2013 ;26(5):408-411.

[4] Li T, Zhuang Q, Weng X, et al. Cemented versus Uncemented Hemiarthroplasty for Femoral Neck Fractures in Elderly Patients: A Meta-Analysis.PLoS One. 2013;8(7):e68903.

[5] 何双建,叶峥,朱剑,等.老年股骨转子间骨折动力髋螺钉置入内固定失败行全髋关节置换4例[J].中国组织工程与临床康复,2010, 14(17):3210-3212.

[6] Intiso D,Di Rienzo F,Grimaldi G,et al.Survival and functional outcome in patients 90 years of age or older after hip fracture. Age Ageing.2009;38(5):619–622.

[7] Beaulé PE, Lee JL, Le Duff MJ, et al. Orientation of the femoral component in surface arthroplasty of the hip. A biomechanical and clinical analysis.J Bone Joint Surg Am. 2004;86-A(9):2015-2021.

[8] 宋玉成,孟庆才,方锐,等.大头金属-金属髋关节假体与普通全髋关节假体置换效果比较:1年随访[J].中国组织工程研究与临床康复,2009, 13(35): 6845-6849.

[9] Simmermacher RK,Ljungqvist J,Bail H,et al.The new proximal femoral nail antirotation (PFNA) in daily practice: results of a multicentre clinical study. Injury 2008;39(8):932-939.

[10] 范少地,于杰,陈戎波,等.高龄股骨转子间骨折人工关节置换的特点及假体的选择[J].中国组织工程研究与临床康复,2010,14(48): 9061-9064.

[11] 张先龙,叶庭均,曾炳芳.髋关节表面置换技术新进展[J].中华外科杂志,2005,43(20): 1355-1357.

[12] Han SK, Lee BY, Kim YS, et al. Usefulness of multi-detector CT in Boyd-Griffin type 2 intertrochanteric fractures with clinical correlation. Skeletal Radiol. 2010;39(6):543-549.

[13] 廖元军.应用扩髓与非扩髓交锁髓内钉治疗闭合性胫骨骨折临床疗效观察[J].河南外科学杂志,2013,19(3):34-35.

[14] 袁堂波,黄立新,蒋建农,等.双极人工股骨头置换术与全髋关节置换术治疗老年股骨颈骨折疗效比较[J].实用骨科杂志,2013, 19(6): 485-488.

[15] Girard J, Lavigne M, Vendittoli PA, et al.Biomechanical reconstruction of the hip: a randomised study comparing total hip resurfacing and total hip arthroplasty. J Bone Joint Surg Br.2006;88(6):721-726.

[16] Klein M, Scherger B, Bernd H, et al. Complications after hip resurfacing using the ASR prosthesis in patients with osteoarthritis.Z Orthop Unfall. 2008;146(2):179-184.

[17] 敖沸,彭小龙,贾芝和,等.人工股骨头置换术治疗老年粉碎性股骨粗隆间骨折45例[J].中国老年学杂志,2012,32(21):4810-4811.

[18] 邵明,庞刽峰,殷振宇,等.老年骨质疏松症股骨颈骨折术后抗骨质疏松治疗的初步观察[J].中华关节外科杂志,2009,3(5):40-41.

[19] 邵亮,徐耀增,耿德春,等.亚洲型股骨近端抗旋髓内钉治疗不稳定型股骨转子问骨折的效果观察[J].中国医药导报,2013,10(12): 166-168.

[20] 梁文清,赵晓峰,徐国健,等. 股骨近端防旋髓内钉与股骨近端锁定加压钢板治疗股骨转子间骨折合并髋内翻效果比较[J].中国乡村医药,2013,20(10):26-29.

[21] 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.

[22] 戚珊红,徐辉豪,施百寿,等.锁孔和锁钉杆过渡配合交锁髓内钉内固定骨折断端的生物稳定性[J].中国组织工程研究,2013,17(22): 4137-4143.

[23] Liu W, Zhou D, Liu F, et al. Mechanical complications of intertrochanteric hip fractures treated with trochanteric femoral nails. J Trauma Acute Care Surg. 2013;75(2):304-310.

[24] Gadegone W,Lokhande V,Salphale Y,et al.Long proximal femoral nail in ipsilateral fractures proximal femur and shaft of femur. Indian J Orthop. 2013;47(3):272-277.

[25] 吕刚,陈平波,吕发明.新一代股骨近端髓内钉INTERTAN内植物应用特征并19例回顾[J].中国组织工程与临床康复,2009,13(26): 5162-5166.

[26] 邵明,毕郑刚,贺胜,等.人工关节置换与髓内钉固定治疗高龄严重骨质疏松股骨转子间骨折的疗效比较[J].中华创伤骨科杂志, 2013, 15(5):402-406.

[27] Sehmisch S,Rieckenberg J,Dresing K.Stabilization of unstable intertrochanteric fractures with the proximal femoral nail. Oper Orthop Traumatol. 2013;25(1):63-83.

[28] 王振东,樊强,李永德.人工股骨头置换术治疗高龄不稳定粗隆间骨折的疗效观察[CD].中华损伤与修复杂志:电子版,2011,6(1): 74-78.

[29] 梁昌详,詹世强,肖丹,等.老年骨质疏松性股骨转子间骨折的治疗策略[J].中国矫形外科杂志,2013,21(12):1247-1248.