The efficacy of proximal femoral nail anti-rotation and artificial thigh bone arthroplasty on old patients with unstable femoral intertrochanteric fracture

XU Qing-li; FAN Yong; WANG Xing-yuan; LI Yu-jun; WANG Shi-zheng

doi:10.3969/j.issn.1009-4237.2017.02.007

Abstract：Objective To evaluate the safety and efficacy of proximal femoral nail anti-rotation ( PFNA) and artificial thigh bone arthroplasty ( ATBA ) on old patients with unstable femoral intertrochanteric fracture . Methods The clinical data of 63 cases of elderly unstable femoral intertrochanteric fracture was retrospective ana-lyzed.Among them 35 cases were treated with PFNA (PFNA group),and the other 28 cases were treated with AT-BA (ATBA group).The average operation time,intraoperative blood loss,blood transfusion volume,postoperative drainage ,postoperative load time and Harris score of the last follow-up were compared between the two groups .Re-sults The average operation time ,intraoperative blood loss ,blood transfusion volume ,postoperative drainage ,postop-erative load time and Harris score of the last follow-up in PFNA group were (42.9 ±11.8) min,(84.2 ±27.5) mL, (85.3 ±20.6) mL,(65.3 ±21.6) mL,(28.7 ±10.3) d and (80.9 ±12.5) respectively,while those of ATBA group were(101.1 ±18.7)min,(311.3 ±105.4)mL,(273.1 ±45.5)mL,(217.4 ±35.2)mL,(5.9 ±3.2)d and (77.2 ±14.1) respectively.The average operation time,intraoperative blood loss,blood transfusion volume and postoperative drainage of PFNA group were significantly less than those of ATBA group , and showed significant differences(P<0.05).However,postoperative load time of ATBA group were significantly less than that of PFNA group(P<0.05).The Harris score of the last follow-up in PFNA group was significantly higher than that of ATBA group(P<0.05).Conclusion PFNA is the first treatment for old patients with unstable femoral intertrochanteric fracture and serious osteoporosis .But for patients with early load demand ,ATBA is more appropriate .