The Clinical Efficacy For Treatment For Inside Wall And Lateral Wall Defect Types Senile Intertrochanteric Fractures With Proximal Femoral Nail Antirotation

Objective: To provide reference for improving the curative effect of intertrochanteric fracture and reducing the risk of internal fixation failure By comparasion and analysis of the treatment for inside wall and lateral wall defect types senile intertrochanteric fractures with Proximal Femoral Nail Antirotation(PFNA).Methods: 50 patients who underwent PFNA from June 2014 to December 2016 were involved in this study,includes 24 males and 26 females.The mean age was 64.5 years(range,50-87 years).The mechanism of this injury was fall damage in 26 cases,motor vehicle accidents in 18 and falls from heights in 6.According to the imaging data,it was divided into two groups.Group A was 22 cases,includes 11 cases of type A2.1,8 cases of type A2.2 and 3 cases of type A2.3,which was inside wall defect types senile intertrochanteric fractures.Group B,lateral wall defect types senile intertrochanteric fractures,was 28 cases,includes 15 cases of type A3.1 and 13 cases of type A3.2.The evaluation indexes between two groups included healing time,full load walking time,head and neck cutting,coxa deformity and Harris score.Results:All patients were followed-up.The mean followed-up time was 13.6 months(range,6-22 months).No wound infection,skin necrosis,no osteomyelitis and bone disconnection were happened.There was also no limb shortening,coxa deformity,breakage of internal fixation and fixation failure.8 cases of femoral head cutting,6 cases of hip varus,4 cases of delayed healing of fracture happened in Group A.No serious complication was happened.2 cases of femoral head cutting,1 cases of hip varus,1 cases of delayed healing of fracture happened in Group B.Harris score was 90.91% in group A,while 92.86% in group B.The healing time,full load walking time,head and neck cutting and coxa deformity show significance between the two groups,but Harris score show no significance.Conclusions: The treatment of senile intertrochanteric fractures with PFNA,especially for those inside wall defect types,has high femoral head cutting,hip varus and delayed healing of fracture,which showed statistical significance.But Harris score show no significance between two groups.