Comparison Of PFNA And Hemiarthroplasty Of Hip In Treatment Of Intertrochanteric Fracture In Elderly Patients

Objective: To compare the clinic curative effects between the proximal femoral nail anti-rotation (PFNA) and hemiarthroplasty of hip in treatment of intertrochanteric fracture in elderly patients.Methods: A research was conducted for a total of 137 cases related to intertrochanteric fracture in elderly patients. All these 137 cases were treated from March 2006 to September 2008, and 119 of them were followed up. Among the 119 cases, according to the patient's will, the PFNA was employed in 62 cases, included 34 male and 28 female,33 in left and 29 in right, the average age was 71.8. The method of lengthen-stem artificial femoral head replacement was applied in the remaining 57 cases, included 31 male and 26 female,32 in left and 25 in right, the average age was 73.3. Analytical comparisons were then conducted to study the difference between these two methods, including operation time, intraoperative bleeding, postoperative complications and the function changes of hip joint.Results: The follow-up period of the 137 cases ranged from 6 months to 3 years, with an average of 1.8 years. The function of the hip joint was evaluated with the Harris hip score as follows. 1) The PFNA greatly reduced the operation time comparing to the hemiarthroplasty of hip,from 30～95min with an average of 52.34±13.81min to 70～135min with an average of 91.49±15.12min; P<0.05. 2) The intraoperative bleeding was less in the cases using PFNA than those using the hemiarthroplasty of hip, from100～250ml with an average of 142士45ml to 200～500ml with an average of 319士74ml; P>0.05. 3) Statistical significance was revealed by no difference of postoperative complications to the different surgical methods. (P>0.05) 4) The decrease of the Harris hip score indicated that these two operative methods exhibited no obvious difference on the function changes of hip joint. (P>0.05)Conclusions: It is concluded that both the PFNA method and the hemiarthroplasty of hip technology have good clinic curative effects in treatment of intertrochanteric fracture in elderly patients, while the former has advantages on the reduction of operation time and bleeding.