Comparison Of Asian Type Femoral Proximal Anti-rotation Intramedullary Nail And Cemented Artificial Femoral Head Replacement For Treatment Of A1-3 Elderly Intertrochanteric Fracture

Objective To explore the clinical efficacy of Asian type of proximal femoral anti-rotation intramedullary nail(PFNA-?)and cemented artificial femoral head replacement(AFHR)for A1-3 elderly intertrochanteric fractures.Methods From January 2015 to August 2017,the retrospective analysis was done on the complete data of 76 elderly unstable intertrochanteric fractures treated with PFNA-? or AFHR.Of these cases,42 patients were treated with PFNA-? and 34 patients were treated with AFHR.The perioperative index and postoperative complications were compared between the two groups.Harris scores at the time 1,3,6and 12 months after surgery were compared between the two groups.Results PFNA-? group was superior to AFHR group in the operation duration,the incision length and the intraoperative blood loss(P<0.05),but inferior to AFHR group in the load bearing time and the hospitalization time(P<0.05).The intraoperative and postoperative blood transfusion of PFNA-? group was less than that of AFHR group(P<0.05).The complication rate of PFNA-? group was 11.90%,which was not significantly different from that of AFHR group(P>0.05).There was no significant difference in Harris score between the two groups at the time 1 month and 12 months after operation(P>0.05).But Harris scores in the PFNA-? group were significantly lower than those in the AFHR group at the time 3 months and 6 months after operation(P < 0.05).Conclusion For elderly patients with A1-3 intertrochanteric fractures,both PFNA-? and AFHR can achieve satisfactory long-term effects.Compared with AFHRsurgery,PFNA-? surgery has a shorter operation time,less intraoperative blood loss and less surgical trauma.But shorter bedridden time after AFHR surgery promotes early rehabilitation exercise and reduces the duration of hospital stays.In conclusion,both operations have their advantages.