Objective Unstable intertrochanteric fractures （ITFs） are mostly treated by proximal femoral nail antirotation （PFNA）,Inter-Tan,Asian Hip,and other new internal fixation devices.But for complex unstable fractures,...Objective Unstable intertrochanteric fractures （ITFs） are mostly treated by proximal femoral nail antirotation （PFNA）,Inter-Tan,Asian Hip,and other new internal fixation devices.But for complex unstable fractures,such as crushed lateral wall of the greater trochanter,the loss of fixation point on lateral wall slightly reduces the fixing effect.This study aimed to compare the biomechanical strengths between reversed less invasive stabilization system （LISS） and PFNA for treatment of unstable ITFs.Methods Forty synthetic femurs were used to simulate unstable ITFs in vitro and were fixed using the reversed LISS or PFNA.These fractures were divided into two groups depending on whether the lateral wall of the greater trochanter is intact or not （AO classification：31-A2.3 and 31-A3.3,respectively）.The load-displacement of femur,stiffness,ultimate load,and cyclic fatigue resistance were detected using an incremental load test and a dynamic fatigue test through an MTS 858 test system.Results For both 31-A2.3 and 31-A3.3,the vertical sinking displacement （VSD） of the femoral head under 500 N load was insignificantly smaller after treatment with reversed LISS than with PFNA,and when the displacement was 5 mm,the femoral head bore insignificantly greater load.The fixation with reversed LISS resulted in greater axial stiffness of the femur but smaller ultimate load.During the same cycle in the dynamic fatigue test,the VSD was insignificantly smaller with the fixation of reversed LISS.Conclusion Reversed LISS and PFNA have similar biomechanical strength for unstable ITFs.This conclusion should be supported by additional large-size research on basic biomechanics and clinical application.This is the first comparative biomechanical study comparing reversed LISS and PFNA for unstable ITFs.展开更多
Purpose:To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods:The study group is treated...Purpose:To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods:The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results:The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion:The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.展开更多
Purpose To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods The study group is treated...Purpose To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.展开更多
目的探讨股骨近端抗旋髓内钉(proximal femoral nail antirotation,PFNA)内固定联合近端控制技术微创治疗股骨粗隆间骨折的临床效果。方法选择2020年1月—2022年1月南通瑞慈医院收治的150例股骨粗隆间骨折患者参与试验,根据随机数表法...目的探讨股骨近端抗旋髓内钉(proximal femoral nail antirotation,PFNA)内固定联合近端控制技术微创治疗股骨粗隆间骨折的临床效果。方法选择2020年1月—2022年1月南通瑞慈医院收治的150例股骨粗隆间骨折患者参与试验,根据随机数表法分为对照组和观察组。对照组(75例)采取股骨近端锁定钢板治疗,观察组(75例)采用PFNA内固定联合近端控制技术治疗。对比两组各项手术指标、并发症发生率、髋关节功能(Harris Hip Score,Harris)评分。结果观察组各项临床指标结果优于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组(8.00%vs 21.33%),差异有统计学意义(χ^(2)=5.327,P<0.05);观察组Harris评分结果优于对照组,差异有统计学意义(P<0.05)。结论股骨粗隆间骨折患者在临床治疗中采取PFNA内固定联合近端控制技术微创治疗可以显著降低患者的术后并发症发生率、改善术中出血、引流量、骨折愈合时间等指标,Harris评分结果良好。因此,建议临床针对股骨粗隆间骨折患者实施PFNA内固定联合近端控制技术微创治疗。展开更多
文摘Objective Unstable intertrochanteric fractures （ITFs） are mostly treated by proximal femoral nail antirotation （PFNA）,Inter-Tan,Asian Hip,and other new internal fixation devices.But for complex unstable fractures,such as crushed lateral wall of the greater trochanter,the loss of fixation point on lateral wall slightly reduces the fixing effect.This study aimed to compare the biomechanical strengths between reversed less invasive stabilization system （LISS） and PFNA for treatment of unstable ITFs.Methods Forty synthetic femurs were used to simulate unstable ITFs in vitro and were fixed using the reversed LISS or PFNA.These fractures were divided into two groups depending on whether the lateral wall of the greater trochanter is intact or not （AO classification：31-A2.3 and 31-A3.3,respectively）.The load-displacement of femur,stiffness,ultimate load,and cyclic fatigue resistance were detected using an incremental load test and a dynamic fatigue test through an MTS 858 test system.Results For both 31-A2.3 and 31-A3.3,the vertical sinking displacement （VSD） of the femoral head under 500 N load was insignificantly smaller after treatment with reversed LISS than with PFNA,and when the displacement was 5 mm,the femoral head bore insignificantly greater load.The fixation with reversed LISS resulted in greater axial stiffness of the femur but smaller ultimate load.During the same cycle in the dynamic fatigue test,the VSD was insignificantly smaller with the fixation of reversed LISS.Conclusion Reversed LISS and PFNA have similar biomechanical strength for unstable ITFs.This conclusion should be supported by additional large-size research on basic biomechanics and clinical application.This is the first comparative biomechanical study comparing reversed LISS and PFNA for unstable ITFs.
文摘Purpose:To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods:The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results:The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion:The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.
文摘Purpose To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.
文摘目的探讨股骨近端抗旋髓内钉(proximal femoral nail antirotation,PFNA)内固定联合近端控制技术微创治疗股骨粗隆间骨折的临床效果。方法选择2020年1月—2022年1月南通瑞慈医院收治的150例股骨粗隆间骨折患者参与试验,根据随机数表法分为对照组和观察组。对照组(75例)采取股骨近端锁定钢板治疗,观察组(75例)采用PFNA内固定联合近端控制技术治疗。对比两组各项手术指标、并发症发生率、髋关节功能(Harris Hip Score,Harris)评分。结果观察组各项临床指标结果优于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组(8.00%vs 21.33%),差异有统计学意义(χ^(2)=5.327,P<0.05);观察组Harris评分结果优于对照组,差异有统计学意义(P<0.05)。结论股骨粗隆间骨折患者在临床治疗中采取PFNA内固定联合近端控制技术微创治疗可以显著降低患者的术后并发症发生率、改善术中出血、引流量、骨折愈合时间等指标,Harris评分结果良好。因此,建议临床针对股骨粗隆间骨折患者实施PFNA内固定联合近端控制技术微创治疗。
