Comparison Of Curative Effect Of PFNA And InterTAN In The Treatment Of Geriatric Intertrochanteric Fractures

Objective:To analysis the curative effects of two kinds of operations on geriatric patients with intertrochanteric fractures through clinical follow up of the clinical effects and complications of operations of using PFNA intramedullary nail and InterTAN intramedullary nail to provide references for clinical applications.Methods:To carry out retrospective analysis and study on 94 cases of geriatric patients with intertrochanteric fractures who received the treatment of closed reduction PFNA or InterTAN internal fixation in the Orthopedics Department of Hospital of Traditional Chinese Medicine of Lianyungang from June 2016 to June 2018 based on inclusion criteria and exclusion criteria.Among the 94 patients,56 were treated by PFNA and 38 by InterTAN.The operative incision length,operative time,operative blood loss,postoperative non-weight-bearing moving time and hospitalization days of the two groups were compared and analyzed.Patients were followed up for one year after hospital discharge,and the hip joint functions(Harris score),fracture healing time and postoperative complications were compared between the two groups.Relevant data obtained were analyzed by statistical software SPSS25.0.Results:Through analysis on collected data from 94 patients who met the inclusion criteria,we found that there was no significant difference between the PFNA group and the InterTAN group in operative incision length,length of stay,fracture healing time,hip joint function scores at various time after operations(P>0.05).The operative time,bleeding volume during operation and fluoroscopy number of patients during operation in the PFNA group were lower than that of the InterTAN group(P<0.05).The postoperative non-weight-bearing moving time of patients in the InterTAN group is earlier than that of the PFNA group(P<0.05).There was no significant difference in postoperative medical complications between the PFNA group and the InterTAN group(P>0.05).There was no significant difference between the two groups in the complications of incision infection,screw releasing,internal fixation fracture,and the femoral fracture around the internal fixation(P>0.05),but the cutting out rate of screw in InterTAN group was lower than that of PFNA group(P<0.05),and the occurrence rate of coax vara in PFNA group is higher than that of InterTAN group(P<0.05).Conclusion:Both PFNA and InterTAN internal fixation systems provide good clinical effects in the treatment of geriatric intertrochanteric fractures.The operation of PFNA is relatively simple,the operation time is relatively short,the bleeding volume during operation is less,and the tissue injury is smaller,so it is suitable for the geriatric intertrochanteric fractures with relatively poor surgical tolerance.As it provides better stability and rotation resistance,InterTAN is more applicable to patients suffered unstable geriatric intertrochanteric fractures.It is helpful for patients to go to the ground earlier after the operation for functional rehabilitation and to return to normal life as soon as possible.