The Treatment Of Intertrochanteric Fractures With PFNA

Objective : Evaluation of proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures.Methods : Retrospective analysis of 40 cases of intertrochanteric fracture patients. 25 patients (group A) in accordance with the classification Evans-Jensen, 13 cases of type III fracture, 9 of type IV fracture, 3 of type V fracture, the use of closed reduction and proximal femoral intramedullary nail anti-rotation fixation for the treatment.15 patients (group B) in accordance with the classification Evans-Jensen, 9 cases of type III fracture, 3 of type IV fracture, 3 of type V fracture, the use of closed reduction and fixation with Gamma nail in the treatment of group B as a control group. Analysis of the two groups were operating time, blood loss, the follow-up of patients with fracture healing. To use Merled' Aubigne scoring system to assess hip function.Results : All patients with an average follow-up period of 8 months (3-17 months). Group A average operating time of 72±15 minutes, intraoperative bleeding average 124±42 ml, the average fracture healing time of 13 weeks, Merled' Aubigne score:excellent in 19 cases, accounting for 76%, good in 6 cases, accounting for 24%.Group B average operating time of 92±16 minutes, intraoperative bleeding average 174±47 ml, the average fracture healing time of 13 weeks, Merled' Aubigne score: excellent in 11 cases, accounting for 73.3%, good in 4 cases, accounting for 26.7%. Operating time, blood loss between the two groups are significantly different(p<0.05). Bone healing time, Merled' Aubigne score between the two groups no significant difference(p>0.05).Conclusion : Proximal femoral nail anti-rotation and Gamma nail are effective methods in the treatment of intertrochanteric fractures. But compared to Gamma nail, Proximal femoral nail anti-rotation is a short operating time, less bleeding way.