[Effectiveness comparison of proximal femoral nail antirotation and dynamic hip screw for intertrochanteric fractures in the elderly patients].
OBJECTIVE
To compare the effectiveness of the proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in the treatment of elderly patients with intertrochanteric fractures.


METHODS
Between May 2007 and May 2010, 63 elderly patients with intertrochanteric fractures were treated, and fractures were fixed with PFNA in 31 patients (PFNA group) and with DHS in 32 patients (DHS group). There was no significant difference in gender, age, injury cause, disease duration, and fracture type between 2 groups (P > 0.05).


RESULTS
All incisions healed by first intention. The incision length, operation time, and blood loss in PFNA group were significantly less than those in DHS group (P < 0.05). The average follow-up time was 13.6 months in PFNA group and was 13.8 months in DHS group. The fracture healing time was (11.80 +/- 1.32) weeks in PFNA group and was (12.21 +/- 1.26) weeks in DHS group, showing no significant difference (t=1.23, P=0.29). The complication rate was 0 in PFNA group and was 12.5% (4/32) in DHS group, showing no significant difference (P=0.06). After 1 year, Harris hip score of PFNA group (86.55 +/- 10.32) was higher than that of DHS group (80.36 +/- 11.18) (t=2.28, P=0.03).


CONCLUSIONS
There are two surgical methods to treat intertrochanteric fractures in the elderly patient: PFNA and DHS, and each has advantages; for unstable intertrochanteric fractures, PFNA treatment is the first choice.
Department of Orthopedics, Dongfang Hospital of Yangzhou, Yangzhou Jiangsu, 225000, P.R.China. 1334693054@qq.com
Guangyin
G
Shen
D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D005269:Femur / Q000293:injuries / Q000601:surgery; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome