Literature DB >> 31197990

[Effectiveness of proximal femoral nail antirotation assisted by mesh locator for intertrochanteric fracture in the elderly].

Xianmin Wu1, Guangfeng Li1, Guoyun He1, Wang Li1, Deding Liu1, Guoqing Yang1, Yang Fang1, Wang Liu1, Youzhong Zhang2.   

Abstract

OBJECTIVE: To explore the effectiveness of proximal femoral nail antirotation (PFNA) assisted by mesh locator in treatment of intertrochanteric fracture in the elderly.
METHODS: Ninety-four elderly patients with intertrochanteric fractures admitted between August 2014 and July 2017 were selected as the study subjects. They were randomly divided into trial group (48 cases) and control group (46 cases). In trial group, PFNA was implanted assisted by mesh locator after closed reduction; while in control group, PFNA was implanted by conventional method. There was no significant difference between the two groups in terms of gender, age, cause of injury, time from injury to admission, fracture side and classification, and medical complications ( P>0.05). The operation time, intraoperative blood loss, fluoroscopy times, hospital stay, incision length, and complications were recorded. Visual analogue scale (VAS) was used to evaluate the degree of pain at 3 days after operation, and Harris score was used to evaluate hip function before operation and at 3, 6, and 9 months after operation.
RESULTS: Compared with control group, the operation time and incision length of trial group shortened, the blood loss and fluoroscopy times reduced, the pain after operation alleviated obviously; the differences between the two groups were significant ( P<0.05). There was no significant difference in hospital stay between the two groups ( P>0.05). The patients in both groups were followed up 9-12 months, with an average of 10.6 months. X-ray films showed that the fractures healed in both groups, and the healing time in control group was (11.2±3.2) weeks, while that in trial group was (11.6±2.9) weeks, showing no significant difference between the two groups ( t=1.262, P=0.120). There was no significant difference in Harris score between the two groups before operation and at 3, 6, and 9 months after operation ( P>0.05). There was 1 case of incision infection, 2 cases of coxa vara, and 1 case of pressure ulcer in trial group, and the incidence of complications was 8.3%. There was 1 case of coxa vara, 2 cases of pressure ulcer, and 1 case of internal fixation loss in control group, and the incidence of complications was 8.7%. There was no significant difference in the incidence of complications between the two groups (χ 2=0.783, P=0.112).
CONCLUSION: It is feasible to implant PFNA assisted by mesh locator in treatment of intertrochanteric fracture in the elderly. Compared with the traditional operation, it can shorten the operation time, shorten the incision, and relieve the pain after operation.

Entities:  

Keywords:  Mesh locator; elderly patient; intertrochanteric fracture; proximal femoral nail antirotation

Mesh:

Year:  2019        PMID: 31197990      PMCID: PMC8355765          DOI: 10.7507/1002-1892.201808117

Source DB:  PubMed          Journal:  Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi        ISSN: 1002-1892


  4 in total

1.  Treatment of intertrochanteric fractures in elderly highrisk patients: dynamic hip screw vs. external fixation.

Authors:  G H Kazemian; A R Manafi; F Najafi; M A Najafi
Journal:  Injury       Date:  2013-11-27       Impact factor: 2.586

2.  [A clinical study on the relationship of the tail femur distance and the lag screw migration or cutting-out after the third generation of Gamma nail fixation of intertrochanteric fracture].

Authors:  Yu Hou; Qi Yao; Gen'ai Zhang; Lixiang Ding
Journal:  Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi       Date:  2018-01-15

3.  Outcome in 36 elderly patients treated with the Gamma3 Long Nail for unstable proximal femoral fracture.

Authors:  Daniel Westacott; Mike Bould
Journal:  Acta Orthop Belg       Date:  2011-02       Impact factor: 0.500

4.  Predictive variables of open reduction in intertrochanteric fracture nailing: a report of 210 cases.

Authors:  Verónica Jiménez Díaz; Alfonso Carlos Prada Cañizares; Ismael Auñón Martín; Miguel Aroca Peinado; Pedro Caba Doussoux
Journal:  Injury       Date:  2016-09       Impact factor: 2.586

  4 in total

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