Objective:To compare the outcomes of dynamic hip screws(DHS)and intramedullary nailing(IMN)in the treatment of extra-capsular metastatic carcinoma of the proximal femur.Methods:A retrospective case analysis method was...Objective:To compare the outcomes of dynamic hip screws(DHS)and intramedullary nailing(IMN)in the treatment of extra-capsular metastatic carcinoma of the proximal femur.Methods:A retrospective case analysis method was used to examine data of patients with proximal metastatic cancer of the femur who were treated with internal fixation in Department of Orthopaedics,Beijing Friendship Hospital,from January 2007 to December 2018.Blood loss,postoperative pain,functional score,length of stay,and survival rates were compared,and postoperative complications were assessed.Results:Complete follow-up data were available for 33 patients.The mean follow-up period was 12.2±3.6(range:9-32)months and the average age was 72.3±4.7(range:59-83)years old.There were 20 females and 13 males.Twenty-three patients had undergone IMN and 10 DHS,according to bone defects and the patient’s overall condition.The median survival time was 10 months in the IMN group and 11 months in the DHS group.Duration of surgery(t=-7.366,P<0.001)and length of hospital stay(t=-3.509,P<0.001)differed significantly between the two groups.There was one case of breakage of internal fixation in the IMN group.Conclusions:There was no significant difference between DHS and IMN in terms of surgical efficacy.IMN and DHS were different in terms of surgical time and hospital stay.However,due to the limited number of cases in this study,multi-factor analysis has not been performed and needs to be further verified in future analysis.When developing a surgical plan,it is recommended to consider the patient’s condition and the surgeon’s experience.展开更多
目的分析股骨近端防旋髓内钉(proximal femoral nail anti-rotation in tram edullary,PFNA)与股骨近端交锁髓内钉(interlocking i ntramedullary nail for proximal femur,InterTAN)内固定手术在老年股骨粗隆间骨折患者中的治疗效果。...目的分析股骨近端防旋髓内钉(proximal femoral nail anti-rotation in tram edullary,PFNA)与股骨近端交锁髓内钉(interlocking i ntramedullary nail for proximal femur,InterTAN)内固定手术在老年股骨粗隆间骨折患者中的治疗效果。方法回顾性选取2021年8月—2022年5月南京市江宁医院收治的60例股骨粗隆间骨折患者的临床资料,根据术式不同将其分为PFNA组(n=35)和InterTAN组(n=25),PFNA组患者采用PFNA内固定手术治疗,InterTAN组采用InterTAN内固定手术治疗。比较两组患者的手术指标(手术时间、术中出血量、术后卧床时间,骨折愈合时间)、于术前和术后1周比较两组患者炎症水平[白细胞水平、血清超敏C-反应蛋白(hypersensitive C-reactive-protein,hs-CRP)和白细胞介素-6(interleukin 6,IL-6)水平],于术后3个月、6个月、1年比较患者Harris髋关节评分及术后并发症发生情况。结果PFNA组的手术、术后卧床和骨折愈合时间均短于InterTAN组,术中出血量少于InterTAN组,差异有统计学意义(P均<0.05)。术后1周,两组患者白细胞、hs-CRP、IL-6水平均高于术前,且PFNA组白细胞、hs-CRP、IL-6水平均低于InterTAN组,差异有统计学意义(P均<0.05)。术后3个月、术后6个月和术后1年PFNA组的Harris髋关节评分均高于InterTAN组,差异有统计学意义(P均<0.05)。PFNA组患者的并发症反应率为22.86%(8/35),高于InterTAN组的4.00%(1/25),差异有统计学意义(χ^(2)=4.067,P<0.05)。结论相较于InterTAN,PFNA内固定手术对老年股骨粗隆间骨折患者具有较好的治疗效果,手术时间短,患者术后恢复情况好,髋关节功能改善更佳,患者远期预后较好,但PFNA并发症发生率更高。展开更多
基金Capital’s Funds for Health Improvement and Research(No.2018-1-2072)。
文摘Objective:To compare the outcomes of dynamic hip screws(DHS)and intramedullary nailing(IMN)in the treatment of extra-capsular metastatic carcinoma of the proximal femur.Methods:A retrospective case analysis method was used to examine data of patients with proximal metastatic cancer of the femur who were treated with internal fixation in Department of Orthopaedics,Beijing Friendship Hospital,from January 2007 to December 2018.Blood loss,postoperative pain,functional score,length of stay,and survival rates were compared,and postoperative complications were assessed.Results:Complete follow-up data were available for 33 patients.The mean follow-up period was 12.2±3.6(range:9-32)months and the average age was 72.3±4.7(range:59-83)years old.There were 20 females and 13 males.Twenty-three patients had undergone IMN and 10 DHS,according to bone defects and the patient’s overall condition.The median survival time was 10 months in the IMN group and 11 months in the DHS group.Duration of surgery(t=-7.366,P<0.001)and length of hospital stay(t=-3.509,P<0.001)differed significantly between the two groups.There was one case of breakage of internal fixation in the IMN group.Conclusions:There was no significant difference between DHS and IMN in terms of surgical efficacy.IMN and DHS were different in terms of surgical time and hospital stay.However,due to the limited number of cases in this study,multi-factor analysis has not been performed and needs to be further verified in future analysis.When developing a surgical plan,it is recommended to consider the patient’s condition and the surgeon’s experience.
文摘目的分析股骨近端防旋髓内钉(proximal femoral nail anti-rotation in tram edullary,PFNA)与股骨近端交锁髓内钉(interlocking i ntramedullary nail for proximal femur,InterTAN)内固定手术在老年股骨粗隆间骨折患者中的治疗效果。方法回顾性选取2021年8月—2022年5月南京市江宁医院收治的60例股骨粗隆间骨折患者的临床资料,根据术式不同将其分为PFNA组(n=35)和InterTAN组(n=25),PFNA组患者采用PFNA内固定手术治疗,InterTAN组采用InterTAN内固定手术治疗。比较两组患者的手术指标(手术时间、术中出血量、术后卧床时间,骨折愈合时间)、于术前和术后1周比较两组患者炎症水平[白细胞水平、血清超敏C-反应蛋白(hypersensitive C-reactive-protein,hs-CRP)和白细胞介素-6(interleukin 6,IL-6)水平],于术后3个月、6个月、1年比较患者Harris髋关节评分及术后并发症发生情况。结果PFNA组的手术、术后卧床和骨折愈合时间均短于InterTAN组,术中出血量少于InterTAN组,差异有统计学意义(P均<0.05)。术后1周,两组患者白细胞、hs-CRP、IL-6水平均高于术前,且PFNA组白细胞、hs-CRP、IL-6水平均低于InterTAN组,差异有统计学意义(P均<0.05)。术后3个月、术后6个月和术后1年PFNA组的Harris髋关节评分均高于InterTAN组,差异有统计学意义(P均<0.05)。PFNA组患者的并发症反应率为22.86%(8/35),高于InterTAN组的4.00%(1/25),差异有统计学意义(χ^(2)=4.067,P<0.05)。结论相较于InterTAN,PFNA内固定手术对老年股骨粗隆间骨折患者具有较好的治疗效果,手术时间短,患者术后恢复情况好,髋关节功能改善更佳,患者远期预后较好,但PFNA并发症发生率更高。
