Clinical Analysis Of DAA Hemihip Arthroplasty And PFNA In The Treatment Of Senile Intertrochanteric Fracture

Objective:Older population is fracture of high-risk groups,and the incidence of intertrochanteric fractures in the elderly population has been high and because of the age structure of an aging society,the incidence of femoral intertrochanteric fractures in recent years to grow,because of its high morbidity,mortality,has become a serious threat to life and health of elderly patients with one of the fracture types.The purpose of this study was to compare the clinical efficacy of DAA hemihip arthroplasty and PFNA in the treatment of senile intertrochanteric fractures,and to provide a new idea for the treatment of senile unstable intertrochanteric fractures.Method:In this study,a retrospective analysis was used to select 73 elderly patients with Tronzo-EvansⅢ type or type Ⅱ intertrochanteric fracture associated with osteoporosis who were admitted to our hospital from September 2018 to September 2020 and had all completed surgical treatment.Patients were divided into DAA hemihip arthroplasty group and PFNA group according to the surgical methods.There were 32 cases in DAA group and 41 cases in PFNA group.The differences in operation time,intraoperative blood loss,postoperative hidden blood loss,postoperative ground time,hospital stay,postoperative Harris score of hip joint function and incidence of postoperative complications between the two groups were observed and compared,and statistical analysis was conducted.Result:There were no deaths during hospitalization in the two groups.In DAA group and PFNA group,the operative time was(63.67±6.65)min and(39.67±7.45)min,respectively(P<0.05),the intraoperative blood loss was(333.33±201.51),(84.76±48.64)ml(P<0.05),the postoperative time to ground was(4.92±1.44),(11.71±1.90)d(P<0.05),Harris scores were(82.44±4.01),(74.15±3.19)P<0.05),and there was no significant difference in the amount of postoperative recessive blood loss and length of hospital stay between the two groups(P>0.05).A comprehensive analysis of the above data showed that DAA group had longer operation time than PFNA group and more intraoperative blood loss than PFNA group(P<0.05),but it was significantly better than PFNA group in terms of postoperative time to ground and Harris score one month after operation.Conclusion(s):Both hemihip arthroplasty and PFNA,as two conventional surgical methods for the treatment of intertrochanteric fracture of femur in the elderly,can achieve better clinical effects,with shorter operation time and less intraoperative bleeding.DAA group in early postoperative of bed load has obvious advantages and early postoperative recovery,clinically Tronzo-Evans Ⅲ type or Ⅳ type of intertrochanteric fracture combination of elderly patients with osteoporosis due to poor stability fracture end,internal fixation of postoperative recovery time is long,prone to other related complications,DAA line into the road early hip replacement can achieve better clinical curative effect.