Retrospectively Analysis Of PFNA And InterTAN For The Treatment Of Unstable Osteoporotic Intertrochanteric Fractures In Elderly Patients

ObjectiveThis study was designed to retrospectively evaluate clinical efficacy of PFNA with InterTAN in the treatment of unstable osteoporotic intertrochanteric fractures in elderly patients, and to discuss advantages and disadvantages of the two internal fixation methods in clinical use by analyzing the data and equipment characteristics.Methods(1)Group:Collecting 37 patients with unstable osteoporotic intertrochanteric fractures hospitalized in Sichuan Provincial People’s Hospital from June 2013 to December 2014.(2)Means:19 patients were treated with PFNA, while the other 18 patients with InterTAN. After surgical operation, all patients received the same treatment and limb functional exercise.(3)Observation:Comparing the two different surgical treatments in terms of operating time, intraoperative blood loss, postoperative flow, incision length, length of hospital stay, fracture healing time, stability of internal fixation and Harris score.ResultsPatients were followed up for 3 months to 15 months, an average of 9.6 months.(1)The comparison results of PFNA with InterTAN in operating time, intraoperative blood loss, postoperative flow and fracture healing time was statistically significant (P<0.05), this illustrates that PFNA is better in operating time, intraoperative blood loss and postoperative flow while InterTAN is better in fracture healing time.(2)In terms of stability of internal fixation, helical blade shift occurred in 1 case of PFNA group while no such case occurred in InterTAN group. But the difference was not statistically significant (P>0.05). This may be related with not enough number of cases and further study is needed, so InterTAN may be better than PFNA in the stability.(3)The comparison results of PFNA with InterTAN in incision length, length of hospital stay and Harris score was not statistically significant (P> 0.05), this illustrates PFNA and InterTAN is similar in these aspects.Conclusion:(1)PFNA and InterTAN are both safe and effective in the treatment of unstable osteoporotic intertrochanteric fractures in elderly patients. Both have the advantages of small operation wound, little intraoperative blood loss, little postoperative flow, stable fracture fixation, short hospital stay and good functional rehabilitation.(2)PFNA and InterTAN compared with each other, each of both has its own advantages and disadvantages. Compared with InterTAN, PFNA group operation is more simple and convenient with shorter operation time, less intraoperative blood loss and less postoperative flow. meanwhile, compared with PFNA, InterTAN group is better in fracture healing time and may be better in stability of internal fixation.