Minimally Invasive Treatment Of Intertrochanteric Femoral Fractures With Proximal Femoral Nail Anti-rotationâ…¡

Objective: To evaluate the clinical effect and operative skills of proximalfemoral nail antirotation-asia(PFNA-II) in treatment of intertrochanteric fractures.Methods: From March2011to June2012,9consecutive cases ofintertrochanteric femoral fractures were treated by PFNA-II.Including16males and23females with an average age of63.31years(range from31to88years),ccording to AOclassification:11patients were type A1,20patients were type A2,8patients were typeA3.The locations were right sides in11cases and left sides in28cases.The patientsunderwent surgery within a mean of5.15days (ranged from3to7days) frominjury.Closed reduction was achieved in all patients.Harris hip scores were used for theevaluation of clinical effect. All patients went through a follow-up examinationrespectively for each of the first, third, sixth, ninth and twelfth months after beingdischarged from the hospital. For each examination, anteroposterior and lateral X rayimages of the broken hip joint were filmed to reflect the healing process of the bonefracture.Results: A total of39consecutive patients were evaluated. The mean operationtime was77.1min (ranged from51to120min) and the mean intra-operative blood losswas85.41ml (ranged from39to185ml).The average follow-up period was16.5months(ranged from12to24months).Post-operative complications included hip coxavara in3patients，hip pain in6patients. No complications such as superficial and deepinfection, deep vein thrombosis, cut-out or breakage of the implants occurred. Allpatients had fracture union.The mean Harris hip score9months postoperatively was 85.2(ranged from61to95).According to Harris hip scores evaluation system,16patients reached an excellent result,16good,6moderate and1poor, with total excellentand good rate of82.1%.Conclusion: PFNA-II with minimally invasive technique is a idea method intreatment of intertrochanteric fractures at the early stage, especially for patients withadvanced age and serious osteoporosis, and fractures with broken lateral femoralwall.Ipsilaterl intertrochanteric and femoral shaft fractures can also be effectivelytreated by long PFNA-II.