Hip & pelvis

The Korean Hip Society (대한고관절학회)
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PFNA and PFN in Intertrochanteric Fractures - Comparison Study of Sliding -

대퇴 전자간 골절에서 항회전 근위 대퇴 골수정과 근위 대퇴 골수정 - 활강의 비교 -

  • Choo, Suk-Kyu (Department of Orthopedic Surgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Oh, Hyoung-Keun (Department of Orthopedic Surgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Choi, Jun-Young (Department of Orthopedic Surgery, Ilsan Paik Hospital, College of Medicine, Inje University)
  • 주석규 (인제대학교 의과대학 일산백병원 정형외과학교실) ;
  • 오형근 (인제대학교 의과대학 일산백병원 정형외과학교실) ;
  • 최준영 (인제대학교 의과대학 일산백병원 정형외과학교실)
  • Published : 2010.03.31
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Abstract

Purpose: This study compared sliding between (a) lag screws of PFN (Proximal Femoral Nail, AO synthes) and (b) the helical blade of PFNA (Proximal Femoral Nail Antirotation, AO synthes) for femoral intertrochanteric fractures. Materials and Methods: We include in our study thirty seven cases who were classified as AO/OTA type A1 femoral intertrochanteric fractures and who underwent hip operations between October 2006 and December 2008. There were 19 patients in the PFN group and 18 in the PFNA group. Degrees of sliding were also measured with postoperative radiology on last follow up compared with immediate postoperative radiology. Both groups were also compared with regard too walking ability using the method of Koval. Results: Average sliding was 5.0${\pm}$2.3 mm for lag screws of the PFN group and 2.8${\pm}$1.3 mm for the helical blade of the PFNA group. The difference was statistically significant (p=0.04). Ambulatory abilities were not statistically different (p=0.33). Conclusion: Patients in the PFNA group have less sliding of the implant, but their walking abilities are similar to patients in the PFN group.

목적: 대퇴골 전자간 골절의 치료에서 근위 대퇴 골수정(PFN)의 지연나사와 항회전 근위 대퇴 골수정의 항회전 나선 칼날의 수술 후 활강 정도를 비교하여 분석하고자 한다. 대상 및 방법: 2006년 10월부터 2008년 12월까지 대퇴골 전자간 골절 중 AO/OTA 분류 A1형으로 수술적 치료를 받은 37명의 환자를 대상으로 하였다. 이 중 PFN을 사용한 환자가 19명이었으며, PFNA를 사용한 환자가 18명이었다. 최종 추시 시에 시행한 단순 방사선 사진을 수술 직후와 비교하여 활강 정도를 측정하였으며, 임상적으로 Koval의 방법으로 수술 후 보행능력을 평가하였다. 결과: PFN의 지연나사 및 PFNA 나선 칼날의 최종 추시 시 활강 정도는 PFN군에서 평균 5.0${\pm}$2.3 mm, PFNA군에서 평균 2.8${\pm}$1.3 mm로 통계적으로 유의한 감소를 보였으며(p=0.04), 추시 기간 중 측정한 보행능력의 경우엔 두 군 간에 유의한 차이가 없었다(p=0.33). 결론: 대퇴골 전자간 골절의 치료에 있어서 수술 후 PFNA의 나선 칼날이 PFN의 지연나사보다 적은 적은 활강을 보였으나, 술 후 보행능력에 있어서는 유의한 차이가 없었다.

Keywords

References

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