| Objective:To compare and analyze the therapeutic effect and complications of DHS and PFNA for treatment of Evans-Jensen ?,? type Intertrochanteric Fracture in the elderly through a retrospective study. Provide clinical evidence for selection of internal fixation of Evans-Jensen ?, ? type Intertrochanteric Fracture in the elderly.Methods:From September 2013 to February 2015,40 patients with Evans-Jensen ?, ? type Intertrochanteric Fracture were enrolled which met the inclusion criteria in the orthopedics department of the Afflicted Hospital of Chengdu University of Traditional Chinese Medicine. They were dived into DHS group and PFNA group according to different surgical methods, and each group had 20 cases. The age, gender, fracture type, preoperative hemoglobin values of the patients were recorded. We compared and analyzed the operation time, incision length, obvious blood loss, hidden blood loss, total blood loss, postoperative hemoglobin values, Harris score at 1,3,6,12 months after surgery, hip function evaluation at the end of follow-up, union time of fracture and occurrence of complications. SPSS 20.0 software was used for statistical analysis.Results:1. Comparison of preoperative data:Two groups of patients with gender, age, fracture classification and preoperative hemoglobin values had no significant difference (P>0.05), so the two groups of patients were comparable.2. Comparison of surgery and blood loss:Compared with the DHS group, PFNA group had shorter operation time, smaller incision length, less obvious blood loss, and the difference was statistically significant (P<0.05); PFNA group had much hidden blood loss, and the difference was statistically significant (P<0.05). The comparison of the total blood loss and postoperative hemoglobin values between the groups had not shown any significantly statistical difference (P>0.05).3. Comparison of postoperative follow-up data:Compared with the DHS group, PFNA group had superior Harris score at 1 months after surgery, and the difference was statistical difference (P<0.05). The comparison of Harris score between the two groups had not shown any statistical difference at 3,6,12 months after surgery (P>0.05). The comparison of the hip function evaluation between the two groups, that was based on the Harris score at the end of follow-up, had not shown any statistical difference (P>0.05).4. Comparison of union time of fracture, occurrence of complications:the comparison of union time of fracture between the groups had not shown any statistical difference (P>0.05). Compared with DHS group, PFNA group had less cases who had complications.Conelusion:1. Both DHS and PFNA are the effective treatment of the Evans-Jensen I, II Intertrochanteric Fracture in the elderly; 2. Compared with DHS group, the PFNA group had much hidden blood loss, but the comparison of the total blood loss and postoperative hemoglobin values between the groups had not shown any significantly statistical difference. It suggests that the two methods in the treatment of Evans the Evans-Jensen I, II Intertrochanteric Fracture in the elderly are consistent with surgical blood loss; 3. Compared with DHS, PFNA has the advantages of shorter operation time, smaller incision length, less obvious blood loss and relatively faster early function recovery. |
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