ObjectiveTo compare the therapeutic effect between intramedullary fixation and external fixation on intertrochanteric fracture. MethodsBetween June 2005 and June 2011, 32 patients with Evans-Jensen type Ⅲ intertrochanteric fracture were treated with proximal femoral nail anti-rotation (PFNA), Gamma nail, dynamic hip screw plate (DHS) or locking compression plate (LCP), separately. The operation duration, peri-operative bleeding, load time, Harris hip score and postoperative complications were observed in the patients, and were used to analyze the therapeutic effect among the four methods. ResultsShorter operation duration, less bleeding in the surgery, smaller quantity of drainage after the operation (P<0.05) were found in group Gamma and group PFNA compared with those in group DHS and LCP. The duration of hospitalization didn't differ much between the two fixation systems (P>0.05). The difference in operation duration, operative bleeding and post-operative drainage between group Gamma and PFNA, and between group DHS and LCP was not significant (P>0.05). ConclusionThe intramedullary fixation was better than external fixation for Evans-Jensen type Ⅲ intertrochanteric fracture.
ObjectiveTo compare the clinical effect of proximal femoral nail antirotation (PFNA) and locking proximal femoral plate (LPFP) for femoral intertrochanteric fracture in elderly patients. MethodsWe respectively analyzed the clinical data of 116 senile patients with femoral intertrochanteric fracture treated between October 2008 and March 2014. Among them, 60 were treated with PFNA, and 56 were treated with LPFP. We compared the two groups of patients in terms of operating time, surgical blood loss, surgical complications, walking exercise time, fracture healing time and joint function recovery. ResultsA total of 115 patients had regular follow-up from 12 to 24 months (averaging 15.7 months). One patient died. The operating time was (83.26±14.81) minutes in PFNA group and (102.58±15.31) minutes in LPFP group. The surgical blood loss was (202.16±33.14) mL in PFNA group and (255.80±45.92) mL in LPFP group. The walking exercise time was (1.80±0.91) weeks in PFNA group and (3.48±3.03) weeks in LPFP group. The fracture healing time was (11.80±2.26) weeks in PFNA group and (12.14±2.21) weeks in LPFP group. The postoperative Harris score for hip joint was 84.56±9.55 in PFNA group and 82.47±9.22 in LPFP group. There were statistical differences in operating time, surgical blood loss and walking exercise time (P<0.05), while no statistical differences were found in fracture healing time and postoperative Harris score for hip joint (P>0.05). ConclusionPFNA and LPFP are effective methods for femoral intertrochanteric fracture in elderly people, but PFNA has a shorter operating time, less surgical blood loss and earlier walking exercise time.