ABSTRACT
Objective To observe the effect of proximal femoral nail anti-rotation(PFNA)combined with salmon calcitonin for the treatment of unstable intertrochanteric fractures in the elderly.Methods A total of 90 elderly patients with unstable intertrochanteric frac-tures were randomly divided into group A,group B and group C(30 cases in each group).Patients in group A received open reduction with DHS,patients in group B got closed reduction with PFNA,and patients in group C received operation as group B but combined with salmon calcitonin after the operation.The intraoperative and postoperative stuation of three groups were compared.Results The intraoperative and postoperative stuation of group B was better than those of group A,the time of weight-bearing exercise and fracture healing in group C was shorter than those of group B(t =4.42;t =5.0,P <0.05).The group B had a less complication than group A(χ2 =7.03,P <0.05).Con-clusion The PFNA has a good restoration effect with shorter operative time,less bleeding and lower complication rate.And combined with the salmon calcitonin,which can shorten the time of recovery.
ABSTRACT
Dynamic hip screw (DHS) fixation is considered standard treatment for most intertrochanteric fractures. However, excessive sliding at the fracture site and medialisation of femoral shaft may lead in fixation failure. In contrast, fixedangled 95 condylar blade plate (CBP) has no effective dynamic capacity and causes little bone loss compared to DHS. We compared the outcome of 57consecutive unstable intertrochanteric fragility fractures treated with these two fixation methods. CBP instrumentation is more difficult requiring longer incision, operating time and higher surgeonreported operative difficulty. The six month post operative mortality rate is 16%. Post operative Harris hip scores were comparable between the two methods. Limb length shortening more than 20 mm was 6 fold more common with DHS. In elderly patients with unstable intertrochanteric fragility fractures, fixed angled condylar blade plate appears to be a better choice than dynamic hip screws for preventing fixation failures.