Comparison Between Longer-stem Hip Arthroplasty And PFNA On The Treatment Of Unstable Intertrochanteric Fractures In Elderly Patients

Objective: To compare the effects of the longer-stem hip arthroplasty and PFNA on elderly patients with intertrochanteric fracture, and look forward reasonable recommendations for treatment,to provide practical advice for the clinicians.Methods: From December 2013 to December 2015, 98 patients aged 60 or older with intertrochanteric fracture admitted to Department of Trauma and Orthopaedics, Affiliated Nanhua Hospital, University of South China, were included in this study. All patients were divided into A,B groups according to treatment modes. For longer-stem hip arthroplasty group A and group B for PFNA.Indices for evaluating effects of the two groups included operative time, blood loss, the size of the incision, bed time, postoperative ambulation time, complications, and according to the Harris hip score were evaluated,the recovery was divided into four levels: excellent, good, medium and poor,and each group’s excellent rate calculated.Results:Operative time of groups A was shorter than the B group;intraoperative blood loss in group A more than group B,and the size of the incision in group A was longer than group B,However,group B in bed time and postoperative ambulation time was significantly longer than group A.P <0.05,there was statistical significance.Incidence of postoperative complications in group A was less than group B, P < 0.05, the was statistical significance, the postoperative complications, in group B were mainly related to the bed time. Harris hip scores in A group were significantly higher than B group in 3 months after surgery(P <0.05).But the two last follow-up scores did not show significant differences.Conclusions: For senile intertrochanteric fracture the two methods are effective treatment.1)PFNA internal fixation treatment:less intraoperative bleeding,less trauma,patients with stable fracture,good general situation,good bone conditions can choose PFNA internal fixation treatment.2)Elderly patients with femoral fractures who underwent arthroplasty have shorter postoperative bed time, more early load time,more faster recovery of hip function, and more higher total effective rate. arthroplasty is a viable option for the elderly patients with femoral fractures.