Compare The Clinical Effect Between InterTAN Nailand PFNA In Treatment Of Intertrochanteric Fractures In The Elderly Patients

Objective : To compare the clinical effect and operative skill of intertrochanteric antegrade nail(Inter TAN nail)and proximal femoral nail antirotation(PFNA)in treatment of intertrochanteric fractures in the elderly patients.Methods : This study analyzed the patient with intertrochanteric fractures,from December 2014 to December 2016,who were accepted in our hospital.To compare the effectiveness between two operation methods,these patients were divided into two groups.Inter TAN nail group contained 23 patients and PFNA group contained 25 patients.Two different operation methods were used to treat these patients,and these patienta were given the same remedies before operation.The time from injury and to operation,operation time,blood loss in operation,hospitalization time,healing time and Harris hip joint functional score were compared between two groups.After being discharged from the hospital,all of the patient were followed-up of the first,the third,the sixth,the ninth and twelfth months.Anteroposterior and later X ray images of the sick hip joint ware filmed to reflected the situation of fracture union,and Harris hip scores were used to evaluate the clinical effectiveness.Results : All of the patient were followed-up,and the operation time of Inter TAN nail group was ranged from 80-150 min,and the mean time was 128.7 ml.The blood loss in operation was ranged from 110-180 ml,and the mean volume was 140 ml;the operation time of PFNA group was ranged from 40-120 min,and the mean time was 68.4 ml.The blood loss in operation was ranged from 50-110 ml,and the mean volume was 83.6 ml.The complication after operation,in Inter TAN nail group,including respiration system infection in 1patient,vein thrombosis of legs in 1patient,hip coxa varus in1 patient,hip pain in 2 patients;in PFNA group,respiration system infection in 1patient,hip coxa varus in2 patient,hip pain in 3 patients.No complication such as incision infection,cut-out and breakage the implants occurred.All of the fractures got union.According to Harris hip joint scores evaluation system,there were 12 patients in excellent result,8 in good,2 in fair,1 in poor(in Inter TAN nail group);there were 13 patients in excellent result,9 in good,1 in fair,2 in poor(in PFNA nail group).Conclusion : Both Inter TAN nail and PFNA can cure intertrochanteric fractures with good result.But PFNA has obvious advantages than Inter TAN nail in sides of less hemorrhage and operation time.