The Comperative Analysis Of The PFNA And DHS In Treatment Of Osteoporotic Intertrochanteric Fractures In The Elderly Patients

Objective Through the summary and analysis about the clinical data and follow-up results of proximal femoral nail antirotation(PFNA) and dynamic hip screw(DHS) the treatment of senile osteoporosis in intertrochanteric fracture,Discussion osteoporotic intertrochanteric fracture fixation in two surgical indications and surgical options,lessons learned,for clinical treatment of osteoporotic intertrochanteric fracture of the surgical methods used to provide a reasonable basis.Methods From October 2006 to December 2008 in Wuhan orthopedic hospital treated a total of over 65 years old patients with intertrochanteric fracture in 106 cases,according to Evans classification,with the exception of typeⅠand typeⅡto stabilize the fracture,the rest of the intertrochanteric fractures are unstable fractures,for a total of 73 cases,nine cases of which removed,a total of 64 cases were followed up.28 cases of which were treated by PFNA,36 cases were treated by DHS.To compare and to assess the treatment in operative time,bleeding volume, intraoperative complications,postoperative drainage,fracture healing time and postoperative functional recovery,postoperative complications,etc.Results In this group 64 cases in all,all patients were followed up to fracture healing for 12-28 months,with an average of 16 months, non-fatal cases.According to Harris hip score of post-traumatic function criteria,The satisfactory rate was 83.6%in PFNA group, higher than the DHS Group's 78%.DHS group and PFNA group at operation time,bleeding volume,postoperative drainage,length of incision,fracture healing time,etc.There were significant differences(P＜0.01).Compared with the DHS group,PFNA group is shorter at operative time,intraoperative medium amount of bleeding and postoperative drainage volume,and fracture healing time shortened,but the number of X-ray exposure is increasing in intraoperative.PFNA group compared with the DHS group at intraoperative complications were statistically significant differences(P＜0.05),PFNA group higher.PFNA group compared with the DHS group at postoperative functional recovery has statistically significant difference(P＜0.01),DHS group poorer.Conclution There is no significant difference in efficacy between two operative methods in treatment the old osteoporotic intertrochanteric fractures.PFNA internal fixation with a minimally invasive operation,less bleeding,fixed solid,fewer complications,is the better internal fixation in treatment the old osteoporotic intertrochanteric fractures.