The Contrast And Analyses Of Surgical Treatment Of Mini Incision Unite Anatomy Locking Compression Titanium Plate And PFNA For The Elder Femoral Intertrochanteric Fractures

Objective: To contrast and analyze of surgical treatment of mini incision unite anatomy locking compression titanium plate and PFNA for the elder femoral intertrochanteric fractures.Methods: From November 2010 to November 2014,102 patients were chosen from our hospital,which were used surgical treatment of the mini incision anatomy locking compression titanium plate or PFNA to treat the elder femoral intertrochanteric fractures.It includes 16 males and 37 females,53 cases in the titanium plate group with the average age of 75.3.There were 49 cases in the PFNA group,including18 males and 31 females with the average age of 74.9.Two groups of operations were completed by the same treatment group,including one chief physician,one deputy physician,a physician,three residents.There were no difference in the operation skills and later treatment.The statistical analysis included the operation times of X-ray fluoroscopy,the operative time and the amount of recessive bleeding,dominant bleeding and total bleeding in the operation,the failure rate of internal fixation,the rate of lower extremity deep vein thrombosis,hospital stay,weight-bearing time,the time of the fracture healing,the Harris Hip Scores after the operation of 6,12,18 months.Results: 102 patients were followed up for the period of 9 to 12 months,which was the average month of 22.5.The weight-bearing time in the PFNA group was 14.3± 1.8d.The weight-bearing time of the titanium plate group was 30.4±2.6d.The weight-bearing time between the two groups had a statistical significance difference(P < 0.05).The operation times of X-ray fluoroscopy,the amount of recessive bleeding and total bleeding in the operation in the titanium plate group were 4.5±1.2 times,334.6±122.6 ml,519.8±142.4ml.The operation times of X-ray fluoroscopy,the amount of recessive bleeding and total bleeding in the operation in the PFNA group were 8.9 ±1.4times,448.6±156.6ml,595.3 ± 185.3ml.The differences had statistical significance difference in the the two groups(P<0.05).The operation time,hospital stay,the time of the fracture healing,the failure rate of internal fixation,the rate of lower extremity deep vein thrombosis in the titanium plate group were 75.8±13.2min,19.2±1.0d,85.4 ±10.6,1.89%,3.77%.The operation time,hospital stay,the time of the fracture healing,the failure rate of internal fixation,the rate of lower extremity deep vein thrombosis in the PFNA group were 76.3±12.1min,18.9±1.3d,84.7±12.4d,2.04 %,4.08%.The differences between two groups had statistical significance(P>0.05).The Harris Hip Scores after the operation of 6,12,18 months the titanium plate group were78.4±7.4,84.3±4.7,87.2±4.4.The Harris Hip Scores after the operation of 6,12,18 months the titanium plate group were 77.9 ±9.3,85.5 ±7.3,87.4±3.6 in the PFNA group.The differences of Harris Hip Scores between two groups had no statistical significance(P>0.05).Conclusion: For the elder femoral intertrochanteric fractures,PFNA had an advantage of the shorter weight bearing time than the mini incision anatomy locking compression titanium plate.However,the titanium plate group had more advantages than PFNA in some aspects,which either could reduce the operation times of X-ray fluoroscopy,amount of recessive bleeding and total bleeding in the operation.Therefore,the mini incision anatomy locking compression titanium plate surgical treatment was another ideal operation method to treat the elder femoral intertrochanteric fractures compared with PFNA.