A Comparative Study On Therapeutic Effect Between Artificial Thigh Bone Replace And PFNA For The Treatment Of Unstable Intertrochanteric Hip Fractures In Senile Patients

Objective:To compare the artificial femoral head replacement and the PFNA fixation in the treatment of elderly unstable intertrochanteric fractures of clinical curative effect, for clinical rational treatment to provide some reference and guidance.Materials and methods:A retrospective analysis method, the selection in January 2010-January 2014 in fujian university of traditional Chinese medicine clinical medical school first affiliated hospital, age of 86 cases (75) or higher in patients with type unstable intertrochanteric fractures.27 cases of male, female 59 patients, aged 75-93, an average of 83.6+/-5.1 years old.44 cases classified by Evans Ⅰ c type, Ⅰ type d 44 cases, Ⅱ type 6 cases; 44 cases of fracture on the right side, left 42 cases of fracture, the unique side fracture patients. All the research object for fresh closed fractures, no merger important nerve, blood vessel damage; Preoperative time for 1d～3d after injury. Before the damage of the hip no pain and normal activity. According to treatment method is divided into:artificial femoral head replacement group (group A) 38 cases,48 cases PFNA internal fixation group (group B). Fracture patients were obviously loose change, merging cardio-cerebrovascular disease 58 cases,48 cases of diabetes. Statistical analysis using the SPSS 16.0 software packages on the collected data and index correlation analysis and data processing.Results:Postoperative bed time of artificial femoral head replacement group, shorter than PFNA group (P<0.05), bleeding amount of PFNA group relatively less artificial femoral head replacement group (P<0.05), Two groups of operation time and postoperative complication rate had no significantdifference (P>0.05).postoperative complications occurred in 3 cases of group A, all cases of fat liquefaction of incision. Group B have appeared in 3 cases of postoperative complications, and 2 case of lung infection,1 case appeared to spiral blade wear a femoral head, eventually lead to hip varus deformity.3,6 months after artificial femoral head replacement Harris score higher than PFNA group (P<0.05),12 months after the hip joint function restore PFNA group was obviously better than the artificial femoral head replacement group (P< 0.05).Conclusion:1.The artificial femoral head replacement group, early with the hip function better, were engaged in activities as early as possible, avoid long-term bed caused by various complications; PFNA group internal fixation surgery, blood loss, less trauma, forward hip better functional recovery, and heals almost no long-term complications.2. The artificial femoral head replacement can be used as one of treatment on age (75 years) or higher priority type unstable intertrochanteric fracture on.