Open AccessTreatment of Middle‐up Part Long‐segment Femoral Fracture with Long Proximal Femoral Nail Antirotation
Author(s) -
Lin Yanbin,
Li Renbin,
Xiong Guosheng,
Zhuang Yan,
Xiong Shengren,
Huang Xiangui,
Zhang Yiyuang
Publication year - 2015
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12166
Subject(s) - medicine , surgery , percutaneous , femoral fracture , osteoporosis , blood loss , visual analogue scale , fixation (population genetics) , femur , population , environmental health
Objective To investigate the outcomes of treating middle‐up part long‐segment fractures of the femur by long proximal femoral nail antirotation ( PFNA ‐long). Methods From J une 2006 to D ecember 2013, 139 cases (35 women, 104 men; mean age 48.8, range, 18−86 years) of long‐segment femoral fracture in middle‐up part were treated with long proximal femoral nail antirotation ( PFNA , 320–380 mm) by minimally invasive percutaneous fixation and autogenous iliac bone graft. Fifty‐eight cases were graded as type IA long‐segment femoral fractures (41.73%), 25 type IB (17.99%), four type IC (2.88%), 28 type II (20.14%), 12 type IIIA (8.63%), five type IIIB (3.60%), and seven type IV (5.04%). Clinical efficacy was evaluated with Harris hip function scores and postoperative pain with visual analogue scale. Results The operative time was 35−90 min (mean, 45 min) and mean intraoperative blood loss 78.6 mL (range 30−200 mL). Most patients were walking with assistance 4−10 days postoperatively. All patients were followed up for 3−37 months (mean, 19 months). There were no serious complications. All fractures healed after 2.8–6.8 months (mean, 3.9 months). According to Harris criteria, the clinical results were excellent in 108 patients, good in 22, fair in eight and poor in one. Ninety‐three cases had no pain, 33 mild pain, 13 moderate pain and 25 occasionally needed non‐steroidal analgesics. Conclusion Closed reduction or limited open reduction with PFNA ‐long is an effective treatment for long‐segment femoral fracture in middle‐up part, with good strength in fixation, high rate of fracture union, early functional recovery and low rate of complications.