Short Term Efficacy Of PFNA And Fhr In The Treatment Of Unstable Intertrochanteric Fractures In The Elderly

Objective:To analysis the clinical curative effect of the proximal femoral nail antirotation(PFNA)and femoral head prosthetic replacement(FHR)for elderly patients with unstable intertrochanteric fracture.Methods:By retrospective analysis.The clinical date of elderly patients with unstable intertrochanteric fracture treated by PFNA and FHR were collected from our hospital from July 2014 to July 2016,which divided into two groups of PFNA or FHR.By consulting related cases,we recorded patients’ fracture classification(according to AO classification),complications,operative time,intraoperative bleeding,hospitalization expenses and perioperative complications.Through outpatient follow-up,telephone follow-up,and door-to-door follow-up when necessary,we regularly followed up the postoperative limb bearing time,postoperative complications,hip joint function score(Harris score)and daily life self-care ability(ADL)after operation.The observation target include hospitalization expenses、operation time、intraoperative bleeding and surgical complications 、 postoperative full weight-bearing time 、 hip joint function score(Harris score)and the ability to care for daily life(ADL score)are analyzed.Results:A total of 86 patients who met the inclusion and exclusion criteria were retrospectively analyzed.The age range was 65-92 years old,with an average age of(78.7+6.3)years,including 40 males and 46 females.They were divided into group PFNA and group FHR according to the mode of operation.Group PFNA,24 male and 20 female,age 65-91 years old,average(76.9+6)years old,according to AO classification: A22 type 20 cases,A23 type 16 cases,A31 type 2 cases,and A33 type 6 cases.In group FHR,there were 16 males and 26 females,aged 66-92 years,averaging(80.5+6)years old,according to AO typing: 16 cases of A22,16 cases of A23,2 of A32 type,and 8 of A33 type.There was no significant difference between the two groups in operative time and postoperative complications(P > 0.05).The hospitalization expenses and intraoperative bleeding in the PFNA group were lower than that in the FHR group,and the postoperative full weight-bearing time was significantly longer than that in the FHR group(P<0.05).The FHR group was higher than the PFNA group(P<0.05)in the 3-6 months after the operation of the Hariss score,and no significant difference(P<00.05)was found in the December follow-up.There was no significant difference in ADL score(P>0.05).Conclusion:PFNA and FHR are effective in the treatment of unstable intertrochanteric fractures of the elderly patients.Compared with FHR,PFNA operation has the advantages of less medical expenses and minimally invasive operation.Postoperative hip joint physiological function can completely meet the needs of elderly people’s daily life,but it has the disadvantage of being late on out of bed time compared with FHR treatment.