Dynamic hip screw, proximal femoral nail antirotation and InterTan nail for intertrochanteric fractures

doi:10.3969/j.issn.2095-4344.2015.22.019

Abstract

Abstract:

BACKGROUND: The extramedullary fixation system including dynamic hip screw (DHS) is commonly used in treatment of Intertrochanteric fracture. However, in patients with unstable intertrochanteric fracture, extramedullary fixation system often leads to the failure of fracture fixation. Intramedullary fixation system including both proximal femoral nail antirotation (PFNA) and InterTan nail has been widely used in the treatment of unstable intertrochanteric fractures.
OBJECTIVE: To compare the therapeutic effects of extramedullary fixation system containing DHS, PFNA and InterTan nail in the treatment of intertrochanteric fracture.
METHODS: Literatures were searched in Wanfang, PubMed, Embase, Medline, the Cochrane library to screen literatures published from January 1990 to November 2014. Relevant studies addressing extramedullary fixation system containing DHS, PFNA and InterTan nail were screened.
RESULTS AND CONCLUSION: 346 articles were screened, and 13 of them were in accordance with the inclusion criteria. 1 271 patients with different types of intertrochanteric fracture were assessed in this study. Compared to DHS group, patients treated with PFNA and InterTan nail had shorter operation time and less blood loss. No significant difference in rehabilitation time and Harris score was detected among three kinds of fixation methods. Additionally, PFNA and InterTan nail had a similar effect. These findings verify that compared with DHS, PFNA and InterTan nail can optimize the surgery, but cannot elevate postoperative outcomes.

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

Key words: Bone Nails, Hip Fractures, Femur, Internal Fixators

CLC Number:

R318

Shao Jin, Yang Tie-yi, Wang Zhi, Zhang Yan, Liu Shu-yi. Dynamic hip screw, proximal femoral nail antirotation and InterTan nail for intertrochanteric fractures[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(22): 3543-3549.

Figures/Tables 11

References

[1] Butler M, Forte ML, Joglekar SB, et al. Evidence summary: systematic review of surgical treatments for geriatric hip fractures. J Bone Joint Surg Am. 2011;93(12):1104-1115.
[2] Swart E, Makhni EC, Macaulay W, et al. Cost-effectiveness analysis of fixation options for intertrochanteric hip fractures. J Bone Joint Surg Am. 2014;96(19):1612-1620.
[3] Haidukewych GJ. Intertrochanteric fractures: ten tips to improve results. Instr Course Lect. 2010;59:503-509.
[4] Zhang K, Zhang S, Yang J, et al. Proximal femoral nail vs. dynamic hip screw in treatment of intertrochanteric fractures: a meta-analysis. Med Sci Monit. 2014;20:1628-1633.
[5] Albareda J, Laderiga A, Palanca D, et al. Complications and technical problems with the gamma nail. Int Orthop. 1996; 20(1):47-50.
[6] Miedel R, Ponzer S, Törnkvist H, et al. The standard Gamma nail or the Medoff sliding plate for unstable trochanteric and subtrochanteric fractures. A randomised, controlled trial. J Bone Joint Surg Br. 2005;87(1):68-75.
[7] Windolf J, Hollander DA, Hakimi M, et al. Pitfalls and complications in the use of the proximal femoral nail. Langenbecks Arch Surg. 2005;390(1):59-65.
[8] Chen Y, Liu S, Lin P, et al. Comparative biomechanical study of reversed less invasive stabilization system and proximal femoral nail antirotation for unstable intertrochanteric fractures. Chin Med J (Engl). 2014;127(23):4124-4129.
[9] Li J, Cheng L, Jing J. The Asia proximal femoral nail antirotation versus the standard proximal femoral antirotation nail for unstable intertrochanteric fractures in elderly Chinese patients. Orthop Traumatol Surg Res. 2015;101(2):143-146.
[10] Huang Y, Zhang C, Luo Y. A comparative biomechanical study of proximal femoral nail (InterTAN) and proximal femoral nail antirotation for intertrochanteric fractures. Int Orthop. 2013; 37(12):2465-2473.
[11] Rupprecht M, Grossterlinden L, Ruecker AH, et al. A comparative biomechanical analysis of fixation devices for unstable femoral neck fractures: the Intertan versus cannulated screws or a dynamic hip screw. J Trauma. 2011;71(3):625-634.
[12] Wang Q, Yang X, He HZ, et al. Comparative study of InterTAN and Dynamic Hip Screw in treatment of femoral intertrochanteric injury and wound. Int J Clin Exp Med. 2014;7(12):5578-5582.
[13] Utrilla AL, Reig JS, Muñoz FM, et al. Trochanteric gamma nail and compression hip screw for trochanteric fractures: a randomized, prospective, comparative study in 210 elderly patients with a new design of the gamma nail. J Orthop Trauma. 2005;19(4):229-233.
[14] Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17(1):1-12.
[15] Zeng L, Liang X, Liu Q, et al. The Predictive Value of Circulating Tumor Cells in Ovarian Cancer: A Meta Analysis. Int J Gynecol Cancer. 2015. in press.
[16] Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005;5:13.
[17] Shao Y, Geng Y, Gu W, et al. Prognostic significance of microRNA-375 downregulation in solid tumors: a meta-analysis. Dis Markers. 2014;2014:626185.
[18] Tobias A. Assessing the Influence of a Single Study in the Meta-Analysis Estimate. Stata Tech Bul. 1999;8:15-17.
[19] van Enst WA, Ochodo E, Scholten RJ, et al. Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study. BMC Med Res Methodol. 2014;14:70.
[20] Jiang ZH, Li NJ, Zhu QJ, et al. Comparison of InterTAN and dynamic hip screw in treatment of femoral intertrochanteric fractures. Zhongguo Yishi Jinxiu Zazhi. 2013; 36(5):4-7.
[21] He JP, Zhang SM, Qiao L, et al. Comparative study of the selection of intramedullary fixation in the treatment of femoral intertrochanteric fractures in senile osteoporotic patients. Zhongguo Guzhi Shusong Zazhi. 2013;19(3): 268-270.
[22] Chen H, Yin YS, Chen Y, et al. Comparison of Intertan, PFNA and Dynamic Hip Screw in Treatment of Femorai Intertrochanteric Fractures. Zhongguo Yiyao Zhinan. 2013; 1(35):405-406.
[23] Lin YJ, Li J, Lin YS, et al. Comparison of the curative effect on treatment of intertrochanteric fractures with InterTAN、PFNA and DHS. Jinan Daxue Xuebao: Ziran Kexue yu Yixue Ban. 2014;35(3):294-298.
[24] Deng JF, Zhou S, Niu HQ. Type of intertrochanteric fracture and choice of internal fixation screw. Zhongguo Zuzhi Gongcheng Yanjiu. 2012;16(48):8976-8982.
[25] Wang YG, Chen M, Hu JK, et al. Comparison of three fixations for treatment of intertrochanteric femoral fractures in the elderly. Zhongguo Gu Shang. 2013;26(8):651-655.
[26] Zhang XD, Liu YW, Jia YD, et al. Comparison of Three Fixation for Treatment of Intertrochanteric Femoral Fractures. Shiyong Guke Zazhi. 2014;20(4):350-354.
[27] Garg B, Marimuthu K, Kumar V, et al. Outcome of short proximal femoral nail antirotation and dynamic hip screw for fixation of unstable trochanteric fractures. A randomised prospective comparative trial. Hip Int. 2011;21(5):531-536.
[28] 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.
[29] Zou J, Xu Y, Yang H. A comparison of proximal femoral nail antirotation and dynamic hip screw devices in trochanteric fractures. J Int Med Res. 2009;37(4):1057-1064.
[30] Wang XB, Xu YZ, Geng DC, et al. Comparison of the rapeutic effect of Pfna with Dhs for intertrochanteric fractures in elderly patients. Suzhou Daxue Xuebao: Yixue Ban. 2010;30(3):639-641.
[31] Zuo WS, Dai ZT, Tian JW. Comparison of therapeutic effect of PFNA with DHS in intertrochanteric fractures. Zhongguo Xiandai Yixue Zazhi. 2011;21(4):475-478.
[32] Lai XL, Li F, Liu DX, et al. Comparison of the rapeutic effect of Pfna with Dhs for intertrochanteric fractures. Zhongguo Yishi Jinxiu Zazhi. 2011;34(26):70-72.
[33] Simmonds MC, Higgins JP, Stewart LA, et al. Meta-analysis of individual patient data from randomized trials: a review of methods used in practice. Clin Trials. 2005;2(3):209-217.

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