Abstract：【Objective】 To explore the clinical efficacy of proximal femoral anti rotation intramedullary nail (PFNA) and InterTan internal fixation in the treatment of intertrochanteric fractures of the femur. 【Methods】 A retrospective analysis was conducted on 100 patients with intertrochanteric fractures of the femur admitted to our hospital from February 2018 to February 2022. They were divided into PFNA group and InterTan group based on different surgical methods, with 50 patients in each group. The perioperative related indicators, fracture healing time, postoperative complications, blood routine, D-dimer (D-D), pain score, ability of daily living, and clinical efficacy were compared between the two groups.【Results】The surgical time, hospitalization time, and intraoperative blood loss in the PFNA group were lower than those in the InterTan group, with statistically significant differences (P<0.05). The incidence of postoperative complications in the PFNA group was 10.00% (5/50), which was higher than 4.00% (2/50) in the InterTan group, and the difference was statistically significant(χ2=6.061, P<0.05). Seven days after surgery, the levels of HCT and Hb in both groups of patients were lower than those before surgery (P<0.05), while D-D levels were higher than those before surgery (P<0.05). The levels of HCT and Hb in the InterTan group were lower than those in the PFNA group (P<0.05), and D-D levels were higher than those in the PFNA group (P<0.05). Three months after surgery, the VAS score and Barthel score of both groups of patients were higher than those before surgery (P<0.05), while the InterTan group was higher than the PFNA group (P<0.05). There was no statistically significant difference in the total effective rate between the InterTan group and the PFNA group (P>0.05). 【Conclusion】The efficacy of InterTan in the treatment of intertrochanteric fractures of the femur is comparable to that of PFNA. It is necessary to comprehensively evaluate the patient's basic condition and choose an appropriate internal fixation method before surgery, but there are relatively few postoperative complications of InterTan.
李铁军. PFNA与InterTan治疗不稳定股骨转子间骨折的临床疗效[J]. 医学临床研究, 2023, 40(7): 1032-1035.
LI Tie-jun. Clinical Efficacy of PFNA and InterTan in the Treatment of Unstable Intertrochanteric Fractures of the Femur. JOURNAL OF CLINICAL RESEARCH, 2023, 40(7): 1032-1035.
[1] 闫军,周劲松,李雷,等.闭合复位加长型股骨近端防旋髓内钉内固定治疗股骨干骨折合并同侧股骨粗隆间骨折[J].中国微创外科杂志,2015,23(2):163-166.
[2] 李森. PFNA和锁定钢板内固定治疗股骨转子间骨折的疗效观察[J].实用手外科杂志,2022,36(4):551-554.
[3] 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):60-62.
[4] 朱涛,周瞳瞳,谢军,等.侧卧位股骨近端防旋髓内钉内固定治疗老年股骨粗隆间骨折的临床体会[J].中国骨与关节损伤杂志,2018,33(4):399-400.
[5] STAMBOUGH J B,NUNLEY R M,CURRY M C,et al. Rapid recovery protocols for primary total hip arthroplasty can safely reduce length of stay without increasing readmissions[J].J Arthroplasty,2015,30(4):521-526.
[6] TANG P F,HU F,SHEN J,et al. Proximal femoral nail antirotation versus hemiarthroplasty:a study for the treatment of intertrochanteric fractures[J].Injury,2012,43(6):876-881.
[7] 方丁,曾义高,陈先洲,等.动力髋螺钉与股骨近端防旋髓内钉内固定治疗股骨粗隆间骨折疗效分析[J].中国骨与关节损伤杂志,2015,30(8):867-868.
[8] 许德慧,易梦秋,王晶.股骨近端防旋髓内钉内固定治疗高龄患者股骨粗隆间骨折的临床效果分析[J].医学综述,2014,20(24):4579-4580.
[9] NÜCHTERN J V, RUECKER A H, SELLENSCHLOH K, et al. Malpositioning of the lag screws by 1 or 2-screw nailing systems for pertrochanteric femoral fractures:a biomechanical comparison of gamma 3 and intertan[J].J Orthop Trauma,2014,28(5):276-282.
[10] 蒋晖,田佳林,谭海鹰.D-D、CRP 水平与胫骨骨折内固定术后深静脉血栓发生率的相关性[J].医学临床研究,2018,35(4):664-666.
[11] 陈伯亮,魏玉珊,赵轶男,等.InterTan髓内钉、PFNA内固定治疗老年不稳定股骨粗隆间骨折围手术期失血量对比观察[J].山东医药,2017,57(1):67-70.
[12] 陈宇翔,唐佩福.股骨粗隆间骨折内固定手术治疗的研究进展[J].解放军医学院学报,2017,38(2):171-178.
[13] 蔡腾,彭强,王冰一,等. 股骨近端防旋髓内钉内固定手术治疗老年股骨转子骨折的效果及对髋关节功能的影响[J].中华实验外科杂志,2022,39(10):2018-2021.
2023, Vol. 40 
