The Comparison Of Clinical Efficacy On The Treatment Of Elderly Intertrochanteric Fracture By PFNA And ALP

Objective:Through retrospective analysis of proximal femoral nail anti-rotation(PFNA) and anatomic proximal femoral locking plate (ALP) type treatment of elderly unstable intertrochanteric fracture curative effect comparison, discusses two types of internal fixation for old type unstable intertrochanteric fracture of surgical indications, clinical reference for the treatment of the disease.Method:A retrospective analysis of the collected Orthopaedics, Xiangya Hospital, Central South University, Hunan Province People’s Hospital orthopedic trauma admitted from January2010to January2013period71cases of unstable intertrochanteric fractures, including35males and36females, aged60～89years, mean age71.3±12.1years,38cases of the left and right33cases. According to AO classification, A2type45cases, A326cases. Random Application PFNA with proximal femoral anatomic locking plate for treatment,39cases in which the PFNA group, ALP group of32patients. Record incision length, operative time, blood loss, postoperative drainage, postoperative ambulation load time, whether the patient follow-up of internal fixation loosening, varus, fracture healing time, and1year after suffering from hip function (Harris score) and other indicators, and statistical analysis. Results:71patients were followed up for12to24months, an average of16.8±2.4months. Locking plate group:incision length12～16cm (average13.72±1.20cm); operative time80-120min (average97.50±11.07min); blood loss was150～300ml (average184.94±62.86ml); postoperative drainage146.9～342.2ml (average232.72±41.29ml); loading time after8～12weeks (average9.80±1.45weeks); fracture healing time13～17weeks (average13.93±1.12weeks);1year after Harris hip score:Excellent in19cases, good in10cases, medium3cases, and poor0cases, good rate of93.5%. PFNA group:incision length of6-8cm (average7.10±1.19cm); operation time50～90min (average70.51±12.76min); blood loss was100～250ml (average142.05±46.97ml); postoperative drainage84.5～289.4ml (average162.04±51.71ml); postoperative weight-bearing time2～4weeks (average2.64±0.74weeks); fracture healing time10～13weeks (mean10.79±1.10weeks);1year after Harris hip score:Excellent in25cases, good in12cases,medium2cases, and poor0cases, good rate of94.8%. Locking plate group postoperative screw cutting one case, two case of hip varus. Results based on statistical analysis software SPSS17.0obtained Tips in incision length, operative time, blood loss, postoperative drainage, postoperative complications, load time, fracture healing time and the two groups of indicators between statistical significance (P<0.05); in hip function (Harris score) recovery on the index difference between the two groups was not statistically significant.Conclusion:PFNA treatment of eldlery intertrochanteric femoral fractures with less trauma, less bleeding, stable fixation, fracture healing and shorter time than the ALP.