Abstract：【Objective】To investigate the clinical effect of proximal femoral anti-rotation intramedullary nail (PFNA) with spiral blade in the treatment of femoral intertrochanteric fracture (FIF). 【Methods】The clinical data of 108 patients with FIF admitted to the Baoji Sixth People's Hospital, Shaanxi Province from June 2017 to May 2022 were retrospectively analyzed. According to different treatment methods, they were divided into PFNA group (PFNA internal fixation, n=57) and dynamic hip screw (DHS) group (DHS internal fixation, n=51). The surgical indexes, hip function, imaging indexes (femoral neck trunk Angle, femoral anterior inclination Angle), lower extremity function, life ability score and complication rate were compared between the two groups. 【Results】The operative time and blood loss in the PFNA group were less than those in the DHS group (all P<0.05). There was no significant difference in the first weight-bearing time and fracture healing time between the two groups (all P>0.05). The good and excellent rate of hip joint Harris score in PFNA group was higher than that in DHS group (P<0.05). There was no significant difference in femoral neck trunk Angle and femoral anterior inclination Angle between the two groups 6 months after operation (P> 0.05). The lower limb Function Scale (LEFS) score and Barthel index score of both groups at 6 months after surgery were higher than those before surgery (both P<0.05). There was no significant difference in LEFS score and Barthel index score between the two groups 6 months after surgery (P>0.05). There was no significant difference in the total incidence of postoperative complications between the two groups (P>0.05). 【Conclusion】Spiral blade PFNA internal fixation is effective in the treatment of FIF, which can improve the quality of life of patients. It has good safety, which is worthy of clinical application.
[1] 刘畅, 韩树峰. 股骨近端联合拉力交锁髓内钉与股骨近端防旋髓内钉、亚洲型股骨近端防旋髓内钉内固定治疗老年转子间骨折的Meta分析[J].中国组织工程研究, 2021, 25(3):477-485.
[2] 江惠祥, 朱聪, 高明明,等. 体表精准定位微创开口技术在PFNA内固定治疗老年股骨粗隆间骨折术中的应用[J].中国骨与关节损伤杂志, 2020, 35(2):167-169.
[3] 罗志权,叶蜀新,刘广大,等. 股骨近端防旋髓内钉与联合加压交锁髓内钉治疗老年股骨转子间骨折的疗效比较研究[J].现代生物医学进展,2018,18(13):2554-2557.
[4] 李鹏程, 王楠, 赵伟,等. ERAS理念对PFNA治疗老年股骨转子间骨折术后谵妄和预后的影响[J].安徽医学, 2021, 42(11):1228-1231.
[5] 徐驰, 周勇, 赵军,等. PFNA治疗老年股骨转子间骨折的隐性失血分析[J].中国矫形外科杂志, 2018, 26(6):510-515.
[6] 邵进, 杨铁毅, 王治,等. 动力髋螺钉、股骨近端抗旋髓内钉与联合加压交锁髓内钉系统修复股骨转子间骨折[J].中国组织工程研究, 2015, 19(22):7-11.
[7] 中国老年医学学会骨与关节分会创伤骨科学术工作委员会. 老年髋部骨折诊疗专家共识(2017)[J].中华创伤骨科杂志, 2017(11):921-927.
[8] PAYAL A R, SOLA-DEL V D, GONZALEZ-GONZALEZ L A, et al. American Society of Anesthesiologists classification in cataract surgery: results from the ophthalmic surgery outcomes data project[J].J Cataract Refract Surg,2016,42(7):972-982.
[9] MEIER S T. Construct validity of outcome rating scale (ORS) scores in clinical samples: extension of harris, murphy, and rakes' (2019) narrative review[J].J Evid Based Soc Work (2019), 2020, 17(6):648-661.
[10] ALNAHDI A H. Measurement properties of the 15-item Arabic lower extremity functional scale[J].Disabil Rehabil,2021, 43(26):3839-3844.
[11] REIS N F D, BISCARO R R M, FIGUEIREDO F C X S, et al. Early rehabilitation index: translation and cross-cultural adaptation to brazilian portuguese; and early rehabilitation barthel index: validation for use in the intensive care unit[J].Rev Bras Ter Intensiva,2021, 33(3):353-361.
[12] 梁宁,江军,邱海滨,等. 股骨近端防旋髓内钉与联合加压交锁髓内钉治疗股骨转子间骨折的短期疗效比较[J].中国组织工程研究,2017,21(31):4989-4994.
[13] 李明,袁伟,程少文. 股骨近端防旋髓内钉与联合拉力交锁髓内钉治疗不稳定性转子间骨折的比较[J].中国中医骨伤科杂志,2016,24(7):33-36.
[14] 黄照国,张财义,张庆,等. 股骨近端防旋髓内钉与联合加压交锁髓内钉治疗老年股骨转子间骨折的疗效比较[J].中国组织工程研究,2020,24(21):3310-3314.
[15] 吕家兴, 白磊鹏, 金宇,等. PFLCP与PFNA治疗老年股骨转子间骨折伴骨折侧中重度膝骨性关节炎患者的效果比较[J].临床误诊误治, 2020, 33(12):51-56.
[16] 宋矿朋, 刘向林, 马超. INTER-tan与PFNA内固定治疗老年股骨粗隆间骨折的疗效及安全性分析[J].重庆医学, 2021, 50(14):2485-2488.
[17] 陈诚, 彭俊才, 苏勇. 动力髋螺钉与股骨近端抗旋髓内钉治疗股骨粗隆间骨折患者围术期指标髋关节功能的影响[J].河北医学, 2020, 26(3):415-418.
[18] 白彦逵. 不同手术方法治疗老年股骨转子间骨折的对照研究[J].实用临床医药杂志,2016,20(17):113-115.
[19] 颛宇,牛康. 交锁髓内钉与股骨近端防旋转髓内钉治疗老年股骨转子间骨折的临床效果[J].临床医学研究与实践,2021,6(33):93-96.
2024, Vol. 41 
