PFNA Therapy for Intertrochanteric Fracture of Incomplete Lateral Wall Type in the Elderly / 天津医药

ABSTRACT

Objective To explore the initial effects of the treatment of proximal femoral nail-helical blade (PFNA) in elderly patients with intertrochanteric fracture of the incomplete lateral wall type. Methods A total of 25 patients were enrolled in this study including 8 cases of type A2, 17 cases of type A3 according to AO classification. All patients under-went three-dimensional CT scan. In all patients with type A2 fracture, there were 6 cases with coronal plane fracture on the greater trochanter, and PFNA was used instead of DHS when an iatrogenic fracture occurred in 2 patients. All other patients were treated with closed reduction and fixed with PFNA. Results All patients healed and the average healing time was 11 weeks, one patient fell down once again and the fracture occurred on the shaft, when a long PFNA was used, both of the frac-tures healed 14 weeks after surgery. In all of the 25 patients,1 patient died due to cerebral hemorrhage 13 months after sur-gery;2 patients needed walking aids due to the presence of osteoarthritis of the knee and calf muscular venous thrombosis was diagnosed in 3 cases. No complications were found in the other patients, such as infection, nonunion and fixation failure. According to the Harris hip score system, there were 14 cases of“excellent”,8 cases of“good”,2 cases of“fair”and1 pa-tient of“poor”.Conclusion The PFNA treatment can provide a good fixation for intertrochanteric fractures of incomplete lateral wall type, which allow patients to do exercise early and achieve an excellent initial outcome.