Efficacy analysis of artificial femoral head replacement and internal fixation with PFNA in the treatment of unstable femoral intertrochanteric fracture

YAO Shao-ping; SUN Xian-run; LI Wei-chao; GAO Guo-xi; HUANG Kun; GUO Wei; HUANG Jie; WAN Yun-peng

Abstract：Objective To retrospectively analyze the efficacy between artificial femoral head replacement and internal fixation with PFNA in the treatment of osteoporotic unstable femoral intertrochanteric fracture .Methods There were 66 elderly patients with osteoporotic unstable femoral intertrochanteric fracture .Totally 31 cases ac-cepted artificial femoral head replacement with bone cement and 35 cases accepted internal fixation with PFNA .The average operative time ,average perioperative blood loss ,the average time to full weight-bearing and Harris hip score in two groups were compared .All patients were followed up for 12 to 27 months,with an average of 21 months.Re-sults In artificial femoral head replacement group ,the average operation time was (60 ±16) min,the average blood loss amount during operation was 500ml and the average weight-bearing time was 6 days.According to Harris score, 28 cases were excellent(90.3%)and 3 cases were good(9.7%).The average hospitalization expense was (38846 ± 5329.6)yuan.In PFNA group,the average operation time was (79 ±13)min.The average blood loss amount during operation was 514 ml and the average weight-bearing time was 32 days in PFNA group .According to Harris score , the patients with PFNA internal fixation were excellent in 27 cases(77.1%),good in 7 cases(20.0%)and poor in 1 case(2.9%).The average hospitalization expense was (36126 ±6316.6)yuan in PFNA group.There was signif-icant difference ( P<0.05 ) in average operation time , average weight-bearing time and Harris score between two groups.The average bleeding and the average hospitalization expense showed no significant difference (P>0.05). Conclusion Both ways are effective for the treatment of unstable femoral intertrochanteric fracture .Artificial femo-ral head replacement has obvious advantages on pain relief ,early ambulation and functional exercise after operation .