Meta-analysis On Efficacy Of Intertan Nail Versus Proximal Femoral Nail Antiratation(PFNA) In Treatment Of Femoral Intertrochanteric Fructures In Elderly Patients

Background Intertrochanteric fracture is a common type of fracture in the elderly,which often occurs in elderly patients with osteoporosis,accounting for 3% ~ 4% of the total fracture.Objective This study aims to compare the difference between Intertan nail and PFNA in treating femoral intertrochanteric fructures in elderly patients,and evaluate their efficacy by Meta-analysis.With the aging of the social population,the incidence has increased year by year.There are many complications and high mortality,so if there is no absolute contraindication,the clinic advocates active surgical treatment.The application of PFNA and Inter Tan in the treatment of intertrochanteric fracture was more.At present,there is still a great controversy about the choice of the surgical method for treating the intertrochanteric fracture of the elderly patients.The purpose of this paper aims to study two kinds of methods of therapy in the treatment of senile femoral intertrochanteric fracture curative effect and security by meta analysis,thus provide a reference for clinicians surgery scheme formulated.Methods The randomized controlled and retrospective trials for comparing Intertan and PFNA between October 2014 and June 2017 in teratment of femoral intertrochanteric fructures were serched from such foreign databases as Pubmed,Medline,Cochrane Library,etc and such Chinese databases as Wan Fang databases,CNKI,VIP,etc were included.Literature screening,data extraction and quality evaluation were evaluated by two people.Duration of surgery,blood loss,Harris hip score,tip-cortex distance,time to union,complications,wound infection,implant failure and fracture nonunion were compared between Intertan and PFNA.The Rev Man5.3 was used for meta-analysis.Results A total of 918 patients from ten trials were included in this meta-analysis(472 patients treated with Intertan and 446 patients reated with PFNA).The result showed that duration of surgery and blood loss were significantly higher in the Intertan group than in the PFNA.There was no significant difference in time to union,Harris hip score,tip-cortex distance,wound infection and fracture nonunion among groups.However,Intertan has less complicationgs and implant Failure than PFNA.Conclusion Both the Intertan and PFNA are reasonable choices for treatment of the femoral intertrochanteric fructures in elderly patients.PFNA is a appropriate choice for patients with poor health and poorly tolerance.If patients have decent physical condition,Inter Tan is prefered.