Effect Comparison Of Intramedullary Fixation And Joint Replacement In Treatment Of Intertrochanteric Fracture In Aged Patient

Objective:To compare the effect of intramedullary fixation and joint replacement in treatment of intertrochanteric fracture in aged patient, thus choose a suitable clinical therapeutic schedule. Methods:Retrospectively analyzed21cases of intertrochanteric fracture from Apr.2009to May.2011,9of them received PFNA fixation,12cases received femur head replacement. EVANS classification was conducted to classify the fracture, cases in both groups were all EVANS Ⅲ and Ⅳ type. Compare the difference in aspects of incision length, operation time, intraoperative blood loss, post-operative hidden blood loss, time in bed, perioperative death rate and post-operative Harris score. Results:21patients was followed up for12-16months and14months in average, cases in both groups took X-ray reexamination post-operatively, showing that trochanter fracture achieved bony healing, however, one case in PFNA group appeared screw blade cutting femur head and total hip replacement were managed. Implant infection and loosening were not seen in group of joint replacement, no thigh and groin pain were observed. Conclusion:In comparison of intramedullary fixation, joint replacement enables early ambulation. thus normal function of hip and patients’post-operative satisfaction can achieved as well. However, joint replacement has a higher surgical invasion and surgical risk, it requires skills and specific treatment from joint surgeon. Considering curative effect and aspects of complication and patients" satisfaction, joint replacement have more advantage in treatment of intertrochanteric fracture than intramedullary fixation.