To Observe The Clinical Effect Of PFNA Internal Fixation And DHS Fixation Of Intertrochanteric Fractures In The Elderly

ObjectiveDynamic hip screw (Dynamic Hip Screw, DHS) to the clinicaltreatment of senile intertrochanteric fracture with proximalfemoral intramedullary nail anti-rotation (proximal femoralnail anti-rotation, PFNA) control Statistics contrast analysis,evaluation application PFNA withinthe efficacy of thetreatment of senile intertrochanteric fracture fixationmethods provide scientific basis for the PFNA fixed clinical.MethodsThe retrospective analysis of57cases of the orthopaedicsdepartment NO.1,Wuhan Pu Ai Hospital admitted suffering fromsenile intertrochanteric fracture cases,which PFNA fixationfor the treatment group30cases, DHS fixation for the treatmentgroup,27cases as the control group. The physical conditionof the two groups of patients were recorded after admission,Evans-Jensen classification criteria, the type of fracture.Detailed records of the two groups of patients, incision length,surgery duration and the number of surgical bleeding,postoperative functional exercise time and length of hospitalstay were recorded. Regular postoperative follow-up ofpatients to evaluate postoperative recovery and postoperativehip function (Harris score). Statistical comparative analysis of these two groups of patients hospitalized days, thelength of the incision, operative bleeding, surgical results,postoperative complications and hip function (Harris score)use and clinical evaluation.ResultsAll57cases of patients discharged does not appear thecircumstances of the death, were9-16months (mean12.5months)regular postoperative follow-up. The comparison of the twogroups of patients in hospital days above: PFNA group of14-26days, an average of16.48±1.2days, DHS group of10-27days,with an average17.52±2.3days was no significant differencebetween the two groups of patients in hospital days (P>0.05);comparison of the two groups of patients in the operative time:PFNA group of45-90minutes, an average of56.34±9.81minutes, DHS patients surgery duration of70-130minutes, anaverage of91.49±15.12minutes, the two groups of patientsin operation time was statistically significant (P <0.05);comparison of the two groups in the length of the incision above:PFNA group of3-5cm, with an average of4cm, DHS group of10-15cm, an average of12.5cm, two groups patients in the surgicalincision length was statistically significant (P <0.05);comparison of the two groups of patients in the operativebleeding above: PFNA group of100-300ml, an average of142±45ml,200-500ml DHS group, an average of319±74ml The twogroups were statistically significant difference (P <0.05) inthe number of surgical bleeding; comparison of the two groupsof patients in the postoperative complications: the PFNA grouppatients three cases of urinary tract infections, two cases ofrespiratory infections without deep vein thrombosis and malunion the DHS group3cases of urinary tract infection,respiratory infection three cases, hip varus deformitypatients cases and cases of deep vein thrombosis, none of thetwo groups of patients bedsores, prosthesis cutting or turnedloose and hip, the two groups were not fracture healing, twosurgical postoperative complication rate was not statisticallysignificant (P>0.05); PFNA treatment group and the the DHStreatment group in fracture healing time no significantdifference (P>0.05), comparison of the two treatment groupsbefore surgery, after3months,6months and12months of hipfunction Harris score by the difference was not statisticallysignificant (P>0.05). no significant differences inpostoperative hip joint function.ConclusionPFNA with DHS in the treatment of senile intertrochantericfractures in the length of hospital stay and surgical efficacywithout significant difference, but the application PFNAtreatment of senile rotor fractures can reduce the operationtime control of operative bleeding, can alleviate the surgeryon patients again hurt, shorten patients undergoingafter thewalk time, patients with early resumption of health. PFNA moreadvantages than the DHS in the treatment of elderlyintertrochanteric fractures, it is worth the clinicalapplication of large area.