Comparing The Clinical Outcome Between LPFP And PFNA ? In Treatment Of The Intertrochanteric Fractures With Lateral Wall Fracture In The Elder Patients

Purpose:To compare the clinical results between LPNA and PFNA ? in the treatment of intertrochanteric fractures with lateral wall fracture in the elder patients and provide a rationale for the clinical practice.Method:A retrospective analysis of 43 patients of intertrochanteric fractures with lateral wall fracture was performed from December 2009 to March 2015.19 patients were male,24 patients were female and the average age was 76.86±7.03(65-93).16 cases with fracture were in the left and 27 cases were in the right.The average time of preoperative preparation was 4.86±2.44 days(3-18).17 cases were treated by LPFP,and 26 cases were treated by PFNA ?.The operative time,total blood loss,time of postoperative full load,time of fracture healing,number of internal fixation failure,number of revision and Harris hip score in postoperative three months and half year were compared between the two groups.Results:The mean follow-up time of 43 patients were 10.2 months(5-15).The total blood loss in PFNA ? group(711.15±63.71ml)was more than that of LPNA group(525.88±56.69ml).However,the operative time(45.35±6.81mins),the time of postoperative full load(8.04± 1.34 weeks),and time of fracture healing(11.73± 1.56 weeks)in PFNA ?group were less than those of LPNA group(respectively,48.35±6.81 mins,12.88±2.00 weeks,14.53±2.03 weeks).Moreover,the number of internal fixation failure in PFNA? group was 0,while the number of internal fixation failure in LPFP group was 4.Significant difference was observed in these aspects(P<0.05).The Harris hip score in PFNA ? group(83.96±7.78)was significantly higher than that of LPFP group(75.25± 11.23)in postoperative three months.There were not statistically different in the number of revision and the Harris hip score in postoperative half year between the two groups(P>0.05).Conclusion:PFNA ? treatment should be recommended for the elderly patients of intertrochanteric fractures with lateral wall fracture,because of its shorter operation time,less time of postoperative full load,faster function recovery,lower failure rate.But more attention should be payed to its larger blood loss.