Comparison Of Curative Effect Between APFN And PFNA In The Treatment Of Intertrochanteric Fractures In The Elderly

Objective:In this paper,a retrospective clinical study was conducted to investigate the efficacy of the Asian Proximal Femoral Nail(APFN)and the Proximal Femoral Nail Anti-rotation(PFNA)in the treatment of intertrochanteric fractures in elderly Chinese.Methods:This paper retrospectively analyzed the clinical data of 34 elderly Chinese patients with intertrochanteric fracture in our hospital from January 1,2018 to June 31,2020.After strict screening of inclusion and exclusion criteria,they were divided into APFN group(n = 16)and PFNA group(n = 18).Through the analysis and comparison of hospital stay,operation time,intraoperative blood loss,intraoperative fluoroscopy times,postoperative apical distance,starting load-bearing time and fracture healing time,and in-depth discussion on the postoperative follow-up changes of internal fixation position,postoperative complications and hip joint function recovery,we finally determined the therapeutic effect of APFN and PFNA intramedullary fixation whether there is a difference in efficacy.Results:The follow-up process of the two groups was smooth,and the follow-up time was no less than 6 months.And there was no statistical difference in the matching of general data between the two groups(P > 0.05),which was comparable.There were no complications such as screw cutting,fracture of internal fixation,necrosis of femoral head and secondary fracture.There was no significant difference between the two groups in hospitalization days,operation time,intraoperative blood loss,intraoperative fluoroscopy times,postoperative apical distance,weight-bearing time and fracture healing time(P > 0.05).In terms of postoperative thigh pain relief,the VAS scores of APFN group and PFNA group were 1.56 ± 0.81,2.22 ± 0.88(3 months after surgery)and 0.63 ± 0.62,1.39 ± 0.92(6 months after surgery),respectively.It can be seen that the score of the APFN group is lower,and the difference among the two groups had statistical significance(P<0.05).In the meantime,the Harris score of APFN group and PFNA group were68.06 ± 7.15,62.83 ± 7.12(3 months after surgery)and 79.00 ± 5.40,74.56 ± 5.70(6 months after surgery),respectively.The difference among the two groups was statistically significant(P < 0.05).Conclusion:Both APFN and PFNA intramedullary nails are effective internal fixation methods for the treatment of elderly femoral intertrochanteric fractures.However,the degree of postoperative thigh pain in patients treated with APFN is weak,and APFN is better than PFNA in the recovery of hip joint function.However,its long-term functional recovery needs further follow-up.However,the current study is limited by its non-randomness and retrospective,and the number of patients included in the current study is small,so it is necessary to further expand the number of cases and extend the follow-up time,which helps to further illustrate the reliability of this conclusion.