Comparative study of lateral position and half lithotomy position in Asian proximal femur intramedullary nail antirotation system internal fixation for treatment of elderly patients with femoral inter-trochanteric fractures
Zhang Xiaohua, Zhou Shuqing, Yang Bowen, Yu Luxin, Zhu Ming, Liao Youxin, Ye Jian, Zhu Qiuwen.
Abstract：Objective To compare the therapeutic effect of lateral position and half lithotomy position in Asian proximal femur intramedullary nail antirotation system (PFNA-II) for treating the elderly patients with femoral intertrochanteric fractures. Methods A retrospective case control study was made on 141 patients with femoral intertrochanteric fractures admitted to Jiangjin Central Hospital from January 2016 to September 2017, including 54 males and 87 females, aged 65-99 years (mean, 80.4 years). According to AO classification, there were 42 patients with type A1 fractures, 88 with type A2 and 11 with type A3. Of all, 74 patients were stabilized by PFNA-II internal fixation in lateral position (lateral position group) and 67 patients by PFNA-II internal fixation in half lithotomy position (half lithotomy position group).The postural placement time, total incision length, operative time, intraoperative blood loss, fluoroscopy frequency, tip-apex distance, reduction quality, fracture healing time, postoperative complications and Harris hip function at 12 months after surgery were compared between the two groups. Results All patients were followed up for 12-18 months (mean, 12.5 months), except that 13 patients were lost after 9 months, an average of 12.5 months. There were no statistically significant differences in postural placement time, operative time, fracture healing time, and Harris hip score between the two groups (P>0.05). While significant differences were seen between lateral position group and half lithotomy position group regarding the incision length ［(6.5±1.3)cm vs. (7.5±1.5)cm］, intraoperative blood loss ［(84.3±3.1)ml vs. (90.4±3.9)ml］, fluoroscopy frequency ［(13.1±1.9)times vs. (11.2±1.2)times］, tip-apex distance ［(20. 6±2.2)mm vs. (24.4±1.8)mm］, good rate of reduction quality (80% vs. 85%) and implant related complications (5% vs. 2%) (P<0.05 or 0.01). Conclusion For treatment of elderly patients with intertrochanteric fractures, compared to the lateral position，the half lithotomy position in PFNA-II internal fixation can reduce frequency of fluoroscopy, improve quality of fracture reduction and reduce implant-related complications.
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引用本文:
张孝华 周述清 杨博文 余璐鑫 朱明 廖友鑫 叶健 朱秋汶. 侧卧位与半截石卧位下应用亚洲型股骨近端防旋髓内钉治疗老年股骨转子间骨折的疗效比较[J]. 中华创伤杂志, 2020, 36(6): 503-508.
Zhang Xiaohua, Zhou Shuqing, Yang Bowen, Yu Luxin, Zhu Ming, Liao Youxin, Ye Jian, Zhu Qiuwen.. Comparative study of lateral position and half lithotomy position in Asian proximal femur intramedullary nail antirotation system internal fixation for treatment of elderly patients with femoral inter-trochanteric fractures. CHINESE JOURNAL OF TRAUMA, 2020, 36(6): 503-508.
