PFNA InterTan, A Clinical Analysis Of Treating Intertrochanteric Fracture In Aged Patients

Objective:With the increase of China’s population aging, senile intertrochanteric fracture incidence increased year by year. Due to the particularity of elderly patients with body, that kind of treatment method of internal fixation with this special group of elderly patients. The clinical treatment of intertrochanteric fractures in elderly patients with 2 of the most common mode of operation:PFNA and InterTan. Through analysis of clinical operation in the treatment of PFNA and InterTan in old patients with femoral intertrochanteric fracture, compared the clinical effect of two internal fixation methods, summarize their advantages and disadvantages, provides the reference for the operation of intertrochanteric fracture mode selection.Data and Methods:From 2011 March to 2013 March in our hospital were selected in 65 cases, male 33 cases, female 32 cases, age 60-88 years old, average 72 years old. Divided into PFNA group and InterTan group according to different fixation methods. Femoral intertrochanteric fracture type according to Evans intertrochanteric fracture type,34 cases in group PFNA, male 18 cases, female 16 cases, age 65-88 years old, average 76 years old,2 cases of Evans type Ⅰ,5 cases of type Ⅱ, Ⅲ type in 11 cases,10 cases of type IV,6 cases of type Ⅴ. InterTan group of 31 cases, male 15 cases, female 16 cases, age 60～83 years old, average 70 years old,3 cases of type Ⅰ,6 cases of type Ⅱ, 9 cases of type Ⅲ,6 cases of type Ⅳ,7 cases of type Ⅴ Each group contains the Department of internal medicine disease, different levels of group PFNA:respiratory system diseases in 5 cases, cardiovascular system diseases in 10 cases, other diseases in 6 cases. Group InterTan:respiratory system diseases in 4 cases, cardiovascular system diseases in 9 cases, other diseases in 5 cases. Application of PFNA in the two groups respectively to improve the preoperative examination and treatment of the original diseases in Department of internal medicine and treated with InterTan system, we compare the operation time, postoperative blood loss, fracture healing time, postoperative complications and hip function score, after treatment of intertrochanteric fracture of femur.Results:By preoperative hip X-rays statistics PFNA group and InterTan group, two groups of fracture type, statistics during the operation time, blood loss. The patients were followed up for 9-24 months (average 12 months), each follow-up were taken, lateral hip x-rays. The amount of blood loss in group PFNA and group InterTan were respectively (190.2 ± 42.6) ml and (241.5 ± 95.2) ml, (P<0.05) the difference has statistical significance. The operation time of group PFNA was 48 ± 24 m operation, the operation time of InterTan group operation was 60 ± 34 m (P<0.05) had significant difference. Clinical healing time of PFNA group was 13 ± 1.2 in group InterTan, clinical healing time was 14.3 ± 1.8 weeks, clinical healing time was slightly longer in group InterTan than in group PFNA, no significant difference (P>0.05). Group InterTan postoperative Harris hip score the excellent and good rate was 87.1%, PFNA group the postoperative Harris hip score the excellent and good rate was 82.4%(P>0.05) with no significant difference between two groups. After operation, group PFNA had no cases of delayed healing, but the appearance of 1 cases of coax vara. While group InterTan had no coxa vara but delayed healing in 1 cases, (P>0.05) with no significant difference between two groups. The two groups had no limb shortening and internal fixation loosening phenomenon.Conclusion:Application of PFNA in the treatment of intertrochanteric fractures in the elderly, bleeding volume, operation time was superior to InterTan group in the operation, and in the clinical healing time of fracture, complications, postoperative hip function score, no obvious advantage. Both the PFNA and the InterTan system design is reasonable, but each has its own advantages. PFNA simple operation, less tissue damage, in line with the principle of BO.InterTan system, and its theory has anti-rotation higher stability. The treatment has the advantages of simple operation, small incision, less bleeding and fixed firmly by PFNA senile unstable intertrochanteric fractures, is worthy of clinical use, while the InterTan system is more suitable for fracture fixation stability requirements are relatively high and the quality of life of patients with higher requirements than. The two as the implant new requires continuous improvement, to meet the clinical needs to continue to develop.