Proximal femoral nail antirotation versus dynamic hip screw in treating senile intertrochanteric fractures / 中国医师杂志

ABSTRACT

Objective To investigate the clinical effect of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in treating senile intertrochanteric fractures.Methods From February 2006 to December 2014,111 cases of senile intertrochanteric fractures treated with PFNA and DHS at our institution were retrospectively analyzed.Fifty-nine cases were treated with PFNA (average age 77.4 years);and fifty-two cases were treated with DHS (average age 76.1 years).The outcome measures collected for statistical analysis on following aspectsurgical time,blood loss in operation,blood transfused,rate of patients transfused,time to partial weight beating,hospital stay,healing time of fracture,orthopedic complications,reoperation rate and post-operation hip function.The Harris Hip Score was used for functional evaluation.Results One hundred and eleven patients were followed up for 10 to 24 months (average 17.2 months).There were no significant differences between two groups with regard to the functional outcome at 1 year,hospital stay,orthopedic complications and reoperation rate (P ＞ 0.05).There were significant differences between the PFNA group and DHS group with regard to the surgical time [(60.7 ±9.9)min vs (97.5 ± 20.5) min],the blood loss in operation [(169.2 ± 82.1) ml vs (428.8 ± 126.O) ml],per patient concentrated red blood cells transfused [(0.7 ± 0.9) U vs (1.2 ± 1.3) U],blood transfusion rate (35.6％ vs 55.8％) and time to partial weight bearing [(12.9 ± 10.3)d vs (47.0 ± 15.5)d] (P ＜0.01).Conclusions PFNA is an effective method for the treatment of senile intertrochanteric fracture with the advantages of simple operative procedure,minimally invasion,stable fixation and fewer complications.