Does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail?  

作　　者：Seung-Hoon Baek Seunggil Baek Heejae Won Jee-Wook Yoon Chul-Hee Jung Shin-Yoon Kim 

机构地区：[1]Department of Orthopedic Surgery,Kyungpook National University Hospital,Daegu 41944,South Korea [2]Department of Orthopedic Surgery,School of Medicine,Kyungpook National University,Daegu 41944,South Korea [3]Department of Orthopedic Surgery,Goodssen Hospital,Daegu 42010,South Korea

出　　处：《World Journal of Orthopedics》2020年第11期483-491,共9页世界骨科杂志（英文版）

摘　　要：BACKGROUND There are few studies in the literature comparing the clinical outcomes and radiographic results of proximal femoral nail(PFN)and proximal femoral nail antirotation(PFNA)for pertrochanteric femoral fracture(PFF)in elderly patients.AIM To evaluate both clinical and radiographic outcomes after fixation with PFN and PFNA in an elderly patient population.METHODS One hundred fifty-eight patients older than 65 years with PFF who underwent fixation with either PFN or PFNA were included.Seventy-three patients underwent fixation with PFN,whereas 85 were fixed with PFNA.The mean follow-up was 2.4 years(range,1-7 years).Clinical outcome was measured in terms of operation time,postoperative function at each follow-up visit,and mortality within one year.Radiographic evaluation included reduction quality after surgery,Cleveland Index,tip-apex distance(TAD),union rate,time to union,and sliding distance of the screw or blade.Complications including nonunion,screw cutout,infection,osteonecrosis of the femoral head,and implant breakage were also investigated.RESULTS Postoperative function was more satisfactory in patients who underwent PFNA than in those who underwent PFN(P=0.033).Radiologically,the sliding difference was greater in PFN than in PFNA patients(6.1 and 3.2 mm,respectively,P=0.036).The rate of screw cutout was higher in the PFN group;eight for PFN(11.0%)and two for PFNA patients(2.4%,P=0.027).There were no differences between the two groups in terms of operation time,mortality rate at one year after the operation,adequacy of reduction,Cleveland Index,TAD,union rate,time to union,nonunion,infection,osteonecrosis,or implant breakage.CONCLUSION Elderly patients with PFF who underwent PFNA using a helical blade demonstrated better clinical and radiographic outcomes as measured by clinical score and sliding distance compared with patients who underwent PFN.

关 键 词：Pertrochanteric fracture Proximal femoral nail Proximal femoral nail antirotation Sliding distance CUTOUT OUTCOME 

分 类 号：R687.3[医药卫生—骨科学]