Application and Experience of Self-made Curved Guide Needle in the Treatment of Intertrochanteric Fracture of Femur with Proximal Femoral Nail Anti-rotation

ZHOU Wenbin; LUO Shangliang; JIANG Yunrong

doi:10.13919/j.issn.2095-6274.ZHJY202503012

Abstract：Objective To explore the application effect of curved guide pins in PFNA treatment of intertro-chanteric femoral fracture with puncture nailing.Methods The data of 62 elderly patients with intertrochanteric femur fracture treated with PFNA surgical internal fixation in our hospital from January 2022 to January 2024 were retrospectively analysed.There were 26 male patients and 36 female patients.They were aged 56-97 years.Most of the injuries were caused by falls and a few by car accidents.The fractures were classified according to Evans classification:8 cases of type ⅠA,19 cases of type ⅠB,11 cases of type ⅡA,9 cases of type ⅡB,6 cases of type Ⅲ,5 cases of type Ⅳ,and 4 cases of type Ⅴ.The fractures were classified according to Evans' classification.PFNA intramedullary fixation surgery was performed using a curved guide needle with open access.The time taken for the surgical procedure,the amount of blood loss during the surgery,the length of time the patients spent recovering from standing weight-bearing after the surgery,the healing cycle of the fracture,and the functional status of the joint were observed,and the function of the hip joint was evaluated according to the Harris evaluation system.Re-sults All were followed up for 6-18 months.The operation time was 25-76 min and intraoperative bleeding was 50-260 ml.All fractures healed(recovery period was 2-6 months)and no loosening of the proximal heli-cal blade or breakage of the staple was observed.6 cases had mild hip internal rotation with an excellence rate of 90.32％(56/62).55 cases had excellent hip function scores according to the Harris system,6 cases had good hip function scores and 1 case had acceptable hip function scores.good,1 case acceptable,and the overall excellent rate was 93.7％(61/62).Conclusion PFNA intramedul-lary fixation is stable and reliable,which can make pa-tients get out of bed as early as possible;intraoperative operation of homemade curved guide pin into the nail is simple and accurate,which is worthy of clinical promotion.