Application of Different Reduction Supports of the Anterior Medial Cortex in Elderly Intertrochanteric Fractures
1.Department of Emergency and trauma，Yichang Central People’s Hospital，The First College of Clinical Medicine，Three Gorges University
2.Department of Orthopaedics，Yichang Central People’s Hospital，The First College of Clinical Medicine，Three Gorges University
Abstract：Objective To explore the differences of short-term therapeutic effects between positive buttress (PB)，neutral buttress (NEB) and negative buttress(NB) after proximal femoral nail internal fixation (PFNA) internal fixation for elderly intertrochanteric fracture.Methods A total of 87 elderly patients with intertrochanteric fractures treated by PFNA internal fixation in Yichang Central People’s Hospital.According to the relationship between proximal headneck bone fragment and distal femoral medial cortex，the patients were divided into positive buttress group (30 cases)，neutral buttress group (36 cases) and negative buttress group (21 cases).PB group included 13 males and 17 females with average age of (71.42±8.24) years (range：61～89 years).NEB group included 16 males and 20 females with average age of (72.81±16.63) years (range：61～90 years).And NB group included 7 males and 14 females with average age of (70.68±16.59) years (range：63～88 years).The neckshaft angle and femoral neck length were measured before discharge and 6 months after operation.Harris score of hip joint was assessed 12 months after operation.Results At 6 months after surgery，the neck trunk angle reduction and femoral neck shortening in the PB group and NEB group were lower than those in the NB group (P＜0.05)，and the neck trunk angle reduction and femoral neck shortening in the NEB group were lower than those in the PB group (P＜0.05).At 12 months after surgery，the hip Harris score in the PB group and NEB group was higher than that in the NB group (P＜0.05).Conclusion When PFNA internal fixation fore elderly intertrochanteric fractures cannot achieve approximate anatomical reduction，the medial cortex of head neck bone block should be placed slightly medial to the medial cortex of femoral shaft (positive buttress) to avoid negative buttress，which can achieve good hip joint function recovery.
刘恒山，寿康全，朱长谋. 内侧皮质不同复位支撑在老年股骨转子间骨折的临床应用研究[J]. 实用骨科杂志, 2023, 29(9): 782-.
Liu Hengshan，Shou Kangquan，Zhu Changmou. Application of Different Reduction Supports of the Anterior Medial Cortex in Elderly Intertrochanteric Fractures. sygkzz, 2023, 29(9): 782-.
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