ABSTRACT
BACKGROUND: Senile unstable intertrochanteric fractures are usually treated with intramedullary nail fixation, but for stable intertrochanteric fractures, extramedullary fixation and intramedullary nail both can obtain satisfactory curative efficacy. Therefore, surgical options are still a controversy.OBJECTIVE: To investigate the effect of percutaneous compression plate (PCCP) versus proximal femoral nail anti-rotation (PFNA) on the postoperative functional recovery of the elderly with stable intertrochanteric fractures and to observe the rotational stability and nail slipping.METHODS: Totally 86 elderly patients with stable intertrochanteric fracture were randomly divided into two groups, and then underwent PCCP or PFNA. The operation time, intraoperative blood loss, postoperative hemoglobin level, the time of weigh bearing, and fracture healing time were recorded; Harris hip scores at postoperative 4 weeks were detected to assess the functional recovery; the rotation rate of femoral head and incidence of nail slipping at 4 weeks postoperatively,as well as the complications within 6 months postoperatively were analyzed statistically.RESULTS AND CONCLUSION: (1) The intraoperative and postoperative declined levels of hemoglobin in the PFNA group were significantly higher than those in the PCCP group (P < 0.05). (2) There was no significant difference for in the Harris hip scores between two groups at postoperative 4 weeks (P > 0.05). The weight bearing time and fracture healing time in the PFNA group were significantly shorter than those in the PCCP group (P < 0.05). (3) The rotation rate of femoral head and nail slipping in the PFNA group were significantly lower than those in the PCCP group (P < 0.05). (4) The incidence of complications within 6 months postoperatively did not differ significantly between two groups (P > 0.05).(5) These results suggest that there is no significant difference in the postoperative function recovery and complications between PCCP and PFNA in the treatment of senile femoral intertrochanteric fracture fixation. However, PFNA possesses advantages in the rotation rate of femoral head and nail slipping.