Clinical Effect Of PFNA And Gamma Nail In The Treatment Of Femoral Intertrochanteric Fracture In The Elderly

Objective: To determine difference in the clinical effect between PFNA and Gamma nail in the treatment of femoral intertrochanteric fracture in the elderly by comparing their outcome.Methods: 142 patients with intertrochanteric fracture were enrolled in this study at the department of orthopedic,Xinhua hospital affiliated to Shanghai Jiao Tong University,school of medicine from January 2014 to December 2014.There were 78 cases treated with PFNA(34 males,44 females)and 64 cases treated with Gamma nail(22 males,42 females)included in the current study.The operation time,blood loss,intra-operative and post-operative complications and hospital duration were recorded.During the follow-up,the timing of fracture union,Harris scores and the distance of screw displacement were evaluated.Result: 1.No significant different was found in the operation time,intra-operative blood lose,complication rates and hospital duration between PFNA group and Gamma nail group,but the hidden blood lose in PFNA group was significantly less than that in Gamma nail group.2.Post-operative hidden blood lose was significantly more than intraoperative blood lose.The factors influenced postoperative hidden blood loss including: age,gender,classification of fracture,internal fixation method as well as hypertension.3.There was no difference in the duration of fracture union and Harris score between PFNA and Gamma nail group.The displacement of loosen screws were significantly larger in the patients who underwent Gamma nail.Conclusion: PFNA and Gamma nail are both safe and reliable fixations for the femoral intertrochanteric fracture in the elderly,PFNA could be a better choice for complex unstable fracture.Regular blood test should be taken to examine postoperative hidden blood lose.