科研之友
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摘要
The purpose of this study was to compare the clinical outcomes of a novel modified trochanteric entry portal and percutaneous technique with those of the conventional trochanteric entry portal and operative technique for the treatment of intertrochanteric fractures with the Proximal Femoral Nail Antirotation system (PFNA-II) in China. From May 2010 to December 2013, 117 elderly patients with intertrochanteric fractures treated with PFNA-II were randomized into 2 groups. Group A was treated with a modified trochanteric entry portal and percutaneous technique, and group B was treated with a standard trochanteric entry portal and operative technique. The 2 groups of patients were statistically analyzed and compared with respect to surgical trauma based on factors that included surgical time, fluoroscopy usage time, skin incision length, intraoperative blood loss, and postoperative outcomes including hospital stay duration, tip-apex distance (TAD), Harris hip score (HHS), and postoperative medical and surgical complications. The surgical times and skin incision lengths were significantly longer (P<0.001) in group B. The intraoperative blood loss was significantly lower in group A (P<0.001). However, the fluoroscopy time was significantly longer in group A (P=0.012). The TADs in group A (25.03 +/- 4.89) and group B (23.12 +/- 5.73) did not significantly differ (P=0.054). At postoperative months 1 and 3, the HHS was significantly higher in group A (P=0.008 and P<0.001, respectively). The novel modified trochanteric entry portal and percutaneous technique achieved excellent nail position, reduced surgical trauma, and enabled early hip function recovery.
