Proximal femoral nail antirotation for intertrochanteric fractures in elderly patients

Wang Guo-dong; Yuan Tong-zhou; Xu Nuo; Zhu Qi-fei; Fan Lei; Wei Xin-cheng; Yang Ling-yun; Zhang Jin-zhang; Huang Ye

doi:10.3969/j.issn.2095-4344.2014.17.010

Abstract：BACKGROUND:Proximal femoral nail antirotation has a precise positioning device. Smal incision closed reduction was used during implantation after fracture. This method induces few traumas and less damage to blood transportation at the fracture end, and is accorded with“BO”theory and the principle of smal invasive operation for treatment of fracture. <br> OBJECTIVE:To retrospectively analyze the clinical therapeutic effects of proximal femoral nail antirotation for intertrochanteric fractures in senile patients. <br> METHODS:A total of 48 patients with intertrochanteric fractures were enrol ed, including 30 males and 18 females, aged 70-86 years old, averagely 77.3 years. According to AO classification, there were 12 cases of 31-A1, 23 cases of 31-A2 and 13 cases of 31-A3. Closed reduction and proximal femoral nail antirotation were utilized. Fracture healing and the position of the device were understood by regular fol ow-up. Functional recovery of the hip joint was evaluated using Harris score after surgery. <br> RESULTS AND CONCLUSION:Bone union was observed in 48 cases, averagely 4.5 months. Satisfactory reduction was obtained in al intertrochanteric fractures. The position of the nail was satisfactory. No complications appeared such as loosing, prolapse, ineffective fixation, avascular necrosis of the femoral head and coxa vara malformation. During final fol ow-up, Harris score revealed excellent in 31 cases, 14 in good and 3 in average, with an excellent and good rate of 93.7%. Results indicated that proximal femoral nail antirotation for intertrochanteric fractures in elderly patients was in accordance with the requirement of biomechanics, and was safe and effective.