[Preliminary clinical effect of proximal femoral nail anti-rotation to treat femoral intertrochanteric fractures].
OBJECTIVE
To evaluate the primary clinical effect of proximal femoral nail anti-rotation (PFNAR) in treating femoral intertrochanteric fractures, to summarize operation skills and to analyze correlated curative effective influential factors.


METHODS
From July 2006 to May 2007, 19 cases of intertrochanteric fractures (including 8 males, 11 females, aged 45-87 years old) were treated with closed reduction and PFNAR fixation. Fractures were caused by falling. The locations were left sides in 10 cases and right sides in 9 cases. According to AO classification, there were 14 cases of type A2 and 5 cases of type A3. Operative time, volume of blood loss and weight bear time were analyzed, the condition of fracture union was observed and the hip function was evaluated using Harris criterion after 9 months of follow-up.


RESULTS
Operative time ranged 23-78 minutes with an average time of 47 minutes, the volume of blood loss ranged 50-120 mL with an average volume of 85 mL, getting-out-of-bed time ranged 2-14 days with an average time of 7.4 days; the weight bearing time ranged 10-14 weeks with an average time of 12.4 weeks. No intra-operative femoral fractures and no regional or deep infection occurred during hospitalization period. Seventeen cases were followed up from 3 months to 12 months with an average time of 9.4 months, and achieved bone healing within 15-18 weeks with an average time of 16.5 weeks. No complications such as delay healing, coxa vara or coxa valga, cut-out and screw extraction occurred. Fifteen cases were followed up over 9 months; according to the Harris criterion for evaluation, the results were excellent in 13 cases, good in 1 case and fair in 1 case, the excellent and good rate was 93.3%.


CONCLUSIONS
PFNAR has the advantages of micro invasion, easy-to-perform, less blood loss, less bone loss and stable fixation in treatment of unstable comminuted intertrochanteric fracture, especially in old patients with osteoporosis.
Chen
Ying
Y
Peking Union Medical University, Beijing, PR China.
Lin
Peng
P
Yang
Lianfa
L
Li
Zirong
Z
D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged