PFNA And APFN Two Intramedullary Nails For The Treatment Of Elderly Chinese Intertrochanteric Fractures

OBJECTIVE : By comparing the clinical efficacy of two proximal intramedullary nails(PFNA)and Asian proximal femoral nails(APFN)in the treatment of elderly Chinese intertrochanteric fractures,the treatment of elderly Chinese A better surgical method for intertrochanteric fractures provides a basis for clinical treatment.METHODS:This study is a retrospective study and selected 32 patients with intertrochanteric fractures who were admitted to the Department of Orthopedics,the Second Affiliated Hospital of Hunan Normal University and People's Liberation Army No.921 Hospital from July 1,2017 to August 31,2019.,The patients were divided into PFNA group and APFN group,the gender,age,injured limbs,basic diseases(coronary heart disease,hypertension),fracture AO classification and other aspects of the two groups of patients were compared.After statistical analysis,The difference was not statistically significant(P> 0.05)and was comparable.Observe and compare the patient's operation time,intraoperative blood loss,intraoperative fluoroscopy times,hospital stay,postoperative weight-bearing time,fracture healing time,spiral blade caudal protrusion lateral femoral cortex length,apex distance(TAD),postoperative complications(Infection,screw cutting,loosening or rupture of internal fixation,distal femoral fracture,deep vein thrombosis),degree of contraction of the affected femoral neck at 6 months after surgery,VAS score of lateral thigh pain and hip joint at 3 and 6 months after surgery Function Harris score.RESULTS:All 32 patients were followed up after operation,and the follow-up time was 6-24 months(mean 16.00 ± 4.51 month).After the operation time,intraoperative blood loss,hospital stay,apex TAD,postoperative complications(postoperative infection,screw cut,internal fixation loose or broken,distal femoral fracture,deep venous thrombosis),starting to bear weight after surgery In the statistics of time and fracture healing time,the APFN group was less than the PFNA group,but the difference was not statistically significant(P> 0.05);the length of the lateral femoral cortex protruding from the end of the spiral blade,the number of intraoperative fluoroscopy,6 months after surgery In the statistics of the degree of shortening of the affected femoral neck at the time,the values in the APFN group were lower than those in the PFNA group,and the difference was statistically significant(P <0.05);In the statistics of functional Harris score,the APFN group was better than the PFNA group,and the difference was statistically significant(P <0.05).CONCLUSIONS : Both PFNA and APFN intramedullary nails can heal fractures and restore hip function in Chinese elderly patients with intertrochanteric fractures.However,the performance of APFN in the number of intraoperative fluoroscopy,the length of the tail of the head nail protruding from the lateral femoral cortex,the length of the femoral neck shortening at 6 months after surgery,the VAS score of lateral thigh pain at 3 and 6 months after surgery,and the Harris score of hip function Better than PFNA.