scholarly journals PFNA-II Internal Fixation Helps Hip Joint Recovery and Improves Quality of Life of Patients with Lateral-Wall Dangerous Type of Intertrochanteric Fracture

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Weilu Mu ◽  
Junlin Zhou

Objective. To analyze the effect of PFNA-II internal fixation on hip joint recovery and quality of life (QOL) in patients with lateral-wall dangerous type of intertrochanteric fracture. Methods. One hundred and twelve patients with lateral-wall dangerous type of intertrochanteric fracture who underwent surgical treatment in our hospital from May 2017 to May 2019 were selected as the participants of the study. Based on the treatment method, all the enrolled patients were divided into two groups: proximal femoral nail antirotation (PFNA group; n = 59 ) who received closed reduction and minimally invasive PFNA internal fixation and dynamic hip screw group (DHS; n = 53 ) who received internal fixation. The clinical indicators, curative effect, hip function score, pain degree, postoperative QOL score, and complications were compared between the two groups. Results. The operation time, intraoperative blood loss, postoperative drainage volume, and the incidence of postoperative complications in PFNA group were statistically lower than those in DHS group ( P < 0.05 ). The curative effect in PFNA group was notably better than that in DHS group. There were no significant differences in scores of hip function, visual analogue scale (VAS), and QOL between the two groups before operation ( P > 0.05 ). However, the hip function score and QOL score increased in both groups after surgery, and the increase was more significant in the PFNA group, while the VAS score decreased in both groups, and the decrease in PFNA group was more significant ( P < 0.05 ). Conclusion. PFNA internal fixation for the treatment of lateral-wall dangerous type of intertrochanteric fracture has the advantages of short operation time, less intraoperative blood loss, effective improvement of hip joint function, and fewer postoperative complications, which is worthy of clinical application.

2020 ◽  
Vol 148 (7-8) ◽  
pp. 451-454
Author(s):  
Milan Mitkovic ◽  
Sasa Milenkovic ◽  
Ivan Micic ◽  
Igor Kostic ◽  
Predrag Stojiljkovic ◽  
...  

Introduction/Objective. There are extramedullary and intramedullary methods of trochanteric fractures? internal fixation with implants having a lag screw. The objective of this study was to examine the difference in impact of these fixation types on final hip function and health-related quality of life. Method. There were 75 patients treated for a trochanteric fracture, using self-dynamisable internal fixator (SIF group), as an extramedullary method, or gamma nail (GN group), as an intramedullary method. These patients were called for the evaluation of Harris Hip Score (HHS) and SF-12 questionnaire at least two years after surgery. The SF-12 questionnaire has dual expression ? physical component score (PCS) and mental component score (MCS). Results. There were no significant differences between the SIF group and the GN group regarding HHS, PCS, and MCS. Positive correlation was confirmed between HHS, PCS, and MCS, with the strongest relation between HHS and PCS. Negative correlation was confirmed between age and HHS. Conclusion. There was no difference in final hip function and health-related quality of life between SIF and GN methods in trochanteric fractures treatment (p > 0.05). These parameters of outcome were confirmed to have positive interrelation (p < 0.05). Both submuscular presence of extramedullary implant with dimensions of SIF and the need for bone reaming in cephalomedullary fixation were considered not to have significant impact in HHS and SF-12 scores after trochanteric fractures treatment by internal fixation.


2013 ◽  
Vol 2 ◽  
pp. 11
Author(s):  
Yapei Sui

<strong>Objective:</strong> The effect of prospective nursing to lower deep vein thrombosis afer the internal fixation of femoral intertrochanteric fracture was studied. <strong>Method: </strong>80 patients, who treated with the internal fixation of femoral intertrochanteric fracture in the orthopedics department of our hospital between January 2012 and June 2013 were selected, the patients were randomly allocated to control group and test group, 40 cases per group, the control group were treated by conventional nursing measures, while the test group used the prospective nursing measures. Compared the living quality and the lower deep vein thrombosis of two groups.<strong> Results: </strong>For the living quality, the scores of all items in prospective nursing group were better than conventional nursing group. The number of lower deep vein thrombosis in the prospective nursing group was 2 cases and the conventional nursing group was 8 cases, with statistical difference. <strong>Conclusion:</strong> The prospective nursing could reduce the incidence of lower deep vein thrombosis after the internal fixation of femoral intertrochanteric fracture, improved the living quality of such patients after surgery, worth clinical promotion.


Author(s):  
Nikil Sanaba Paramesh ◽  
Usman Taufiq

<p class="abstract"><strong>Background:</strong> Controversy still exists regarding using cemented or uncemented hemiarthroplasty for femoral neck fractures in elderly patients. The aim of this study is to compare the effectiveness and safety of the two surgical techniques in femoral neck fracture patients over 60 years old.</p><p class="abstract"><strong>Methods:</strong> We searched PUBMED from inception to December 2012 for relevant randomized controlled trials (RCTs). Outcomes of interest include postoperative hip function, residue pain, complication rates, mortality, reoperation rate, operation time and intraoperative blood loss. Odds ratios (OR) and weighted mean differences (WMD) from each trial were pooled using random-effects model or fixed-effects model given on the heterogeneity of the included studies.<strong></strong></p><p class="abstract"><strong>Results:</strong> Our control trial involved 132 patients (132 hips) who were eligible for the study. Our results demonstrate that cemented hemiarthroplasty is associated with better postoperative hip function (OR = 0.48, 95% CI, 0.31–0.76; p = 0.002), lower residual pain (OR = 0.43, 95%CI, 0.29–0.64; p&lt;0.0001), less implant-related complications (OR = 0.15, 95%CI, 0.09–0.26; p&lt;0.00001) and longer operation time (WMD = 7.43 min, 95% CI, 5.37–9.49 min; p&lt;0.00001). No significant difference was observed between the two groups in mortality, cardiovascular and cerebrovascular complications, local complications, general complications, reoperation rate and intraoperative blood loss.</p><p class="abstract"><strong>Conclusions:</strong> Compared with uncemented hemiarthroplasty, the existing evidence indicates that cemented hemiarthroplasty can achieve better hip function, lower residual pain and less implant-related complications with no increased risk of mortality, cardiovascular and cerebrovascular complications, general complications, local complications and reoperation rate in treating elderly patients with femoral neck fractures.</p>


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hong-Li Deng ◽  
Yu-Xuan Cong ◽  
Hai Huang ◽  
Bin-Fei Zhang ◽  
Ya-Hui Fu ◽  
...  

Objective. The study is aimed at evaluating the effect of the integrity of lateral wall on the quality of reduction and outcome in intertrochanteric fracture treated with proximal femoral nail antirotation (PFNA). Methods. Medical record systems for elderly patients with intertrochanteric fracture treated with PFNA were included. The patients were divided into incompetent and intact lateral wall groups. Patients’ baseline characteristics, quality of reduction, and Harris Hip scores (HHS) were collected. Results. The study included 115 patients with intertrochanteric fractures, with 59 in the incompetent lateral wall group and 56 in the intact group. Lateral wall thickness was 16.47 ± 2.46  mm and 23.68 ± 1.59  mm in the incompetent group and intact group ( t = − 18.766 , P < 0.001 ), respectively. There was no significant difference in the quality of reduction ( P = 0.646 ) between intact and incompetent groups. Mean HHS at final follow-up were 83.02 ± 13.89 in the incompetent group and 86.04 ± 3.39 in the intact group, with no significant difference ( P = 0.123 ). In addition, there was no significant difference in weight-bearing or clinical healing between intact and incompetent groups. The partial weight-bearing with crutches was allowed at 2.71 ± 0.93 and 2.66 ± 1.01 weeks after the operation in the incompetent and intact groups. Time to clinical healing was 5.83 ± 0.99 and 6.00 ± 0.92 months in the incompetent and intact groups, respectively. However, the operative time in the incompetent group ( 58.54 ± 18.14  mins) were longer than that in the intact group ( 51.79 ± 17.77  mins). Conclusions. In conclusion, it seems that lateral wall thickness does not affect the quality of reduction and outcome in patients with intertrochanteric fracture receiving PFNA.


2021 ◽  
Vol 8 ◽  
Author(s):  
Ye Yuan ◽  
Jianing Jian ◽  
Hailiang Jing ◽  
Ran Yan ◽  
Fengming You ◽  
...  

Background: Although the advantages of single-incision laparoscopic surgery have been reported in several meta-analyses, the low quality of studies included in the meta-analyses limits the reliability of such a conclusion. In recent years, the number of randomized controlled trials on the efficacy of SILS in colorectal cancer has been on the rise. This update systematic review and meta-analysis of RCTs aims to compare efficacy and safety of SILS and CLS in the patients with colorectal cancer.Methods: Relevant data was searched on the CNKI, Wanfang, VIP, Sinomed, PubMed, Embase, and Cochrane CENTRAL databases from inception until February 5th, 2021. All RCTs comparing SILS and CLS were included. The main outcomes were 30 days of mortality, postoperative complications, intraoperative complications, whereas secondary outcomes were the number of lymph nodes removed, duration of hospital stay, intraoperative blood loss, abdominal incision length, reoperation, readmission, conversion to laparotomy, operation time and anastomotic leakage.Results: A total of 10 RCTs were included, involving 1,133 participants. The quality of the included studies was generally high. No significant difference was found between SILS and CLS in the 30 days mortality rate. The results showed that SILS group had a lower rate of postoperative complications (RR = 0.67, 95% CI: 0.49–0.92), higher rate of intraoperative complications (RR = 2.26, 95%CI: 1.00–5.10), shorter length of abdominal incision (MD = −2.01, 95% CI:−2.42–1.61) (cm), longer operation time (MD = 11.90, 95% CI: 5.37–18.43) (minutes), shorter hospital stay (MD = −1.12, 95% CI: −1.89–0.34) (days) compared with CLS group. However, intraoperative blood loss (MD = −8.23, 95% CI: −16.75–0.29) (mL), number of lymph nodes removed (MD = −0.17, 95% CI: −0.79–0.45), conversion to laparotomy (RR=1.31, 95% CI: 0.48–3.60), reoperation (RR = 1.00, 95% CI: 0.30–3.33) and readmission (RR =1.15, 95% CI: 0.12–10.83) and anastomotic leakage were not significantly different between the two groups.Conclusion: These results indicate that SILS did not has a comprehensive and obvious advantage over the CLS. Surgeons and patients should carefully weigh the pros and cons of the two surgical procedures. Further RCTs are needed to prove long-term outcomes of SILS in colorectal cancer.


2020 ◽  
Author(s):  
Bo Liu ◽  
Wenhui Ma ◽  
Sikai Liu ◽  
Xiao Chen ◽  
Mengnan Li ◽  
...  

Abstract Background Fractures involving both the acetabulum and the ipsilateral femoral trochanter are rarely reported. The aims of our study were to identify the etiological characteristics, summarize the treatment methods, and analyze the mid- to long-term prognosis for this kind of rare injury. Methods A total of 18 patients who were treated in our hospital for a combination of ipsilateral acetabular fracture and intertrochanteric fracture from 2003 to 2013 was retrospectively analyzed. The etiology, fracture classifications, treatment and prognosis of patients were identified. Results We followed up with patients for 6.2 years to 16 years. In this study, injuries occurred most commonly via traffic accidents, followed by falls from a tall height and crushing injury. Six patients had posterior dislocation of the hip joint. Evans type 3 fracture and Letournel type 1 fracture were the most common fractures among these patients. All patients received internal fixation for their intertrochanteric fracture. Some patients also received internal fixation for their acetabular fracture. However, for the other patients, acetabular fractures were treated conservatively or with fracture fragment resection. One elderly (87 years) female patient had pulmonary disease and died at 24 days postoperatively. In other patients, fractures all achieved bony healing. Twelve patients achieved excellent and good results (Harris score ≥ 80 points), and 5 patients achieved fair and poor results (Harris score < 80 points). The proportion of patients who achieved an excellent-good Harris score was 70.6%. Dislocation of the hip was found to be an independent risk factor (HR = 9.194, 95% CI = 1.024–82.515) for poor patient outcomes. Conclusion The detailed characteristics of patients with acetabular fracture and ipsilateral intertrochanteric fracture were identified in this study. For patients who undergo surgical treatment, fracture healing is usually achieved. However, the occurrence of complications, especially avascular necrosis, is the major cause of poor prognosis. Dislocation of the hip joint at the time of injury is considered to be an important risk factor for poor prognosis.


2019 ◽  
Vol 34 (11) ◽  
pp. 2763-2769.e1 ◽  
Author(s):  
Ninna Rysholt Poulsen ◽  
Inger Mechlenburg ◽  
Kjeld Søballe ◽  
Anders Troelsen ◽  
Jeppe Lange ◽  
...  

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