Objective To investigate the relationship between nail protrusion and the efficacy of Asian proximal femo-ral nail anti-rotation(PFNA-Ⅱ)for treatment of elderly femoral intertrochanteric fracture.Methods The 217 elder-ly patients of femoral intertrochanteric fractures treated with PFNA-Ⅱfixation were divided into protruding group(115 patients)and non-protruding group(102 patients),according to whether the nail protruded the femoral greater tro-chanter arc after surgery.The case number of the length and distal diameter of different nail,different screw blade po-sition,operation time,fracture reduction quality,callus formation time,fracture healing time and postoperative compli-cations were compared between the two groups.The distance of nail protruding the greater trochanter in the protruding group was recorded.The pain VAS was used to evaluate the tenderness of the femoral greater trochanter region,and Harris score was used to evaluate the functional recovery of the hip joint.Results All patients were followed up for 9～16(13.4±2.1)months.There were no statistical differences between the two groups in the case number of the length and distal diameter of different nail,different screw blade position,operation time,fracture reduction quality,callus formation time,fracture healing time and Harris scores at the last follow-up(P>0.05).At 6 months after sur-gery,the distance of nail protruding the greater trochanter was3.4～19.7(9.5±2.4)mm in the protruding group.The pain VAS,the pain incidence rate of femoral greater trochanteric region and the incidence rate of complications in the protruding group were all higher than those in the non-protruding group(P<0.05).Conclusions Using PFNA-Ⅱ for treatment of the femoral interochanteric fractures in the elderly,the intramedullary nail protrusion in the femoral greater trochanter region is more common,which will lead to an increase in the incidence rate of pain and postopera-tive complications.It is suggested that PFNA-Ⅱshould be further improved to shorten the proximal length of nail so as to obtain more satisfactory clinical effect.
feomral intertrochanteric fracturesproximal femoral nail anti-rotationfracture fixation,intramedullary
万方数据
维普
