Treatment of geriatric osteoporotic femoral intertrochanteric fractures with proximal femoral nail antiro-tation and bone cement enhancement / 中华创伤骨科杂志

ABSTRACT

Objective:To investigate the efficacy of proximal femoral nail anti-rotation (PFNA) plus bone cement enhancement in the treatment of geriatric osteoporotic femoral intertrochanteric fractures.Methods:A retrospective analysis was conducted of the 52 elderly patients with osteoporotic femoral intertrochanteric fracture who had been treated at Department of Bone and Joint Surgery, The Fourth People's Hospital of Guiyang from September 2012 to October 2018 by PFNA internal fixation plus bone cement enhancement. They were 8 males and 44 females, aged from 65 to 91 years (average, 78 years). The time from injury to operation averaged 4.4 d. By the AO/OTA classification, there were one case of type 31-A1.2, 2 cases of type 31-A2.1, 8 cases of type 31-A2.2, 34 cases of type 31-A2.3, one case of type 31-A3.1, and 6 cases of type 31-A3.3. The patients' operation time, intraoperative bleeding, hospital stay, fracture reduction, postoperative weight-bearing time, fracture union time, function of the affected hip and complications were recorded.Results:The operation time for this cohort averaged 79.4 min, intraoperative bleeding 123.6 mL, and hospital stay 11.9 d. By the Francisco evaluation, the reduction of intertrochanteric fracture was assessed as good in 43 cases and as fair in 9 cases. Of this cohort, 45 were followed up for 5 to 12 months (average, 6 months) and 7 lost to follow-up. By the Harris hip scores at the last follow-up, 14 cases were rated as excellent, 25 as good and 6 as fair, giving an excellent to good rate of 88.9% (39/45). No complications like loosening, cut-out or breakage of implants or femoral head necrosis occurred during follow-up.Conclusion:In the treatment of geriatric osteoporotic femoral intertrochanteric fractures, PFNA plus bone cement enhancement can achieve satisfactory clinical efficacy.