Comparison Of Two Intramedullary Nails(PFNA And ZNN) For The Treatment Of Intertrochanteric Fracture Of The Femur In The Elderly

Objective:To compare the clinical efficacy of proximal femoral nail antirotation(PFNA)and zimmer natural nail(ZNN)in the treatment of intertrochanteric fractures in the elderly,and to provide theoretical basis for the selection of clinical treatment.Methods:The patients in the two groups were followed up for 9-24 months,with an average of(19.1 ± 4.7)months.The operation time and blood loss in PFNA group were less than those in ZNN group(P < 0.05);the VAS pain score in ZNN group was better than that in PFNA group(P < 0.05)at 9 months after operation,and there was no significant difference in Harris score of hip between the two groups(P > 0.05),but the pain score in ZNN group was better than that in PFNA group(P < 0.05)There was no significant difference in the score of the range of motion of the hip joint(P > 0.05);there was no necros is of the femoral head,removal of the head nail or pulmonary embolism caused by deep vein thrombosis in the two groups;there were 2 cases of incision infection in the PFNA group and 1 case in the ZNN group(P > 0.05).There was no significant difference in the healing time between the two groups(P > 0.05).Results:the patients in both groups were followed up for at least 9 months.The operation time and blood loss in PFNA group were less than those in ZNN group(P < 0.05);the VAS pain score in ZNN group was better than that in PFNA group(P < 0.05)at 9 months after operation,and there was no significant difference in Harris score of hip between the two groups(P > 0.05),but the pain score in ZNN group was better than that in PFNA group(P < 0.05)There was no significant difference in the score of the range of motion of the hip joint(P > 0.05);there was no necrosis of the femoral head,removal of the head nail or pulmonary embolism caused by deep vein thrombosis in the two groups;there were 2 cases of incision infection in the PFNA group and 1 case in the ZNN group(P > 0.05).There was no significant difference in the healing time between the two groups(P > 0.05).Conclusion:Both PFNA and ZNN can achieve satisfactory results in the treatment of intertrochanteric fracture of femur.Hip and femoral pain is less severe after ZNN internal fixation,especially for the patients with significantly increased anterior arch of femur,ZNN can be used preferentially,the operation time and blood loss of PFNA are less,and PFNA can be used preferentially for the patients with older age and weaker body.