Abstract: Objective To explore and compare the curative effect on the internal fixation of proximal femoral nail anti-rotation(PFNA)，InterTan and anatomic proximal femoral locking plate(APFLP)in the treatment of unstable intertrochanteric fractures in aged．MethodsA total of 90 patients with unstable intertrochanteric fracture collected from April 2009 to April 2014 in our hospital were divided into three groups(n=30)according to internal fixation，and performed PFNA fixation(the PFNA group)，InterTan fixation(the InterTan group)and APFLP fixation(the APFLP group)respectively．The intraoperative blood loss，operation time，length of incision，intraoperative fluoroscopy times，the length of hospital stays，time of fracture healing，hip function outcome(Harris score)，fine rate and postoperative complications were recorded and compared among three groups．ResultsAll cases of three groups were followed up more than one year．Among three groups，the PFNA group had least blood loss and shortest operative time，InterTan group followed，and APFLP group had most blood loss and longest operative time(P ＜0．05)．The length of incision and intraoperative fluoroscopy times of both PFNA group and InterTan group were less than those of APFLP group(P ＜0．05)．There was no statistical difference in the length of hospital stays，fracture healing time，Harris score and fine rate ofhip function among three groups(P ＞0．05)．The postoperative complication rate of APFLP group were higher than the other two groups(P ＜0．05)，but there was no statistical difference between PFNA group and InterTan group(P＞0．05)．ConclusionsAll the internal fixation of PFNA，APFLP and InterTan were suitable for the unstable intertrochanteric fractures in aged．But PFNA was the first choice in consideration of the simple operation procedure，minimally intraoperative trauma and less postoperative complications．
黄金河，赵玉驰，王力刚，许军. PFNA、APFLP及InterTan髓内钉治疗高龄不稳定性转子间骨折临床效果比较[J]. 中国现代手术学杂志, 2017, 21(2): 136-140.
HUANG Jin-he，ZHAO Yu-chi，WANG Li-gang，XU Jun. Effect Comparison on Internal Fixation of PFNA，InterTan and APFLP for Unstable Intertrochanteric Fractures in Aged Patients. Chinese Journal of Modern Operative Surgery, 2017, 21(2): 136-140.
［1]Turgut A，Kalenderer，Günaydm B，et al．Fixation of intertrochanteric femur fractures using Proximal Femoral NailAntirotation(PFNA)in the lateral decubitus position without a traction table［J]．Acta Orthop Traumatol Turc，2014，48(5):513-520．doi:10．3944/AOTT．2014．14．0098．［2]Lee SY，Niikura T，Iwakura T，et al．Complete traumatic backout of the blade of proximal femoral nail antirotation:a case report［J]．Orthop Traumatol Surg Res，2014，100(4):441-443．doi:10．1016/j．otsr．2013．12．028．［3]杨进顺，吕浩然，黄文铎，等．骨质疏松患者转子间骨折不同治疗方法的比较［J]．中华创伤杂志，2008，24(11):884-887．［4]Flores LA，Harrington IJ，Heller M．The stability of intertrochanteric fractures treated with a sliding screw-plate［J]．J Bone Joint Surg Br，1990，72(1):37-40．［5]Jin L，Zhang L，Hou Z，et al．Cephalomedullary fixation for intertrochanteric fractures:an operative technicaltip［J]．Eur J Orthop Surg Traumatol，2014，24(7):1317-1320．doi:10．1007/s00590-014-1430-3．［6]Jiang Y，Li J，Dib HH，et al．Implantation of INTERTANTMnail in four patients with intertrochantericfractures leading to single or comminute fractures:pitfalls and recommendations:a case series［J]．J Med Case Rep，2014，8:383．doi:10．1186/1752-1947-8-383．［7]Russell TA，Sanders R．Pertrochanteric hip fractures:time for change［J]．J Orthop Trauma，2011，25(4):189-190．doi:10．1097/BOT．0b013e3181f221c1．［8]Nüchtern JV，Ruecker AH，Sellenschloh K，et al．Malpositioning of the lag screws by 1-or 2-screw nailing systems forpertrochanteric femoral fractures:a biomechanical comparison of gamma 3 andintertan［J]．J Orthop Trauma，2014，28(5):276-282．doi:10．1097/BOT．0000000000000008．［9]袁晓明，姚琦，倪杰，等．股骨近端防旋髓内钉与动力髋螺钉治疗老年股骨粗隆间骨折的荟萃分析［J]．中华医学杂志，2014，94(11):836-839．［10]Zhong B，Zhang Y，Zhang C，et al．A comparison of proximal femoral locking compression plates with dynamic hipscrews in extracapsular femoral fractures［J]．Orthop Traumatol Surg Res，2014，100(6):663-668．doi:10．1016/j．otsr．2014．06．012．［11]童松林，高益斌，陆文杰，等．微创动力髋螺钉与动力髋螺钉治疗高龄粉碎性股骨转子间骨折的疗效比较［J]．中华创伤杂志，2010，26(3):231-233．［12]Connelly CL，Archdeacon MT．The lateral decubitus approach for complex proximal femur fractures:anatcreduction and locking plate neutralization:a technical trick［J]．J Orthop Trauma，2012，26(4):252-257．doi:10．1097/BOT．0b013e31821e0b2d．［13]Sahin EK，Imerci A，Klnlk H，et al．Comparison of proximal femoral nail antirotation(PFNA)with AO dynamiccondylar screws(DCS)for the treatment for unstable peritrochanteric femoralfractures［J]．Eur J Orthop Surg Traumatol，2014，24(3):347-352．doi:10．1007/s00590-013-1195-0．［14]王东，王起奎，周君琳．股骨近端防旋髓内钉与InterTan髓内钉治疗股骨转子间骨折疗效比较的Meta分析［J]．中华创伤骨科杂志，2014，16(8):668-673．
2017, Vol. 21 
