Comparison of three internal fixation methods for the treatment of stable intertrochanteric fracture of the femur in the elderly
XU Cheng-zhen
YANG Wen-gui
HAN Xue-kun
FANG Wei
SU Zhi-hui
Abstract：Objective To compare the efficacy of Gamma nail,proximal femoral nail anti rotation(PFNA) and dynamic hip screw(DHS)in the treatment of intertrochanteric fractures in the elderly.Methods In this stud-y,336 elderly patients with stable intertrochanteric fracture(type Evans-JensenⅠtoⅡ)in the Department of Or-thopedics in Nanjing Meishan Hospital from Feb.2013 to Aug.2016 were selected,including 108 cases of Gamma nail treatment,137 cases of PFNA treatment,and 91 cases of DHS treatment.The operation time,intraoperative blood loss,postoperative drainage,and fracture healing time were observed and compared.Results The operation time and intraoperative bleeding amount in PFNA group was(68.41 ±17.64)min and(120.07 ±32.42)mL,re-spectively,which were significantly lower than those of Gamma nailing group and DHS group(P<0.05).The post-operative flow rate of the Gamma nail group was(70.46 ±29.87)mL,which was obviously lower than that of the PFNA group and the DHS group(P<0.05); the weight-bearing time of the DHS group was(12.10 ±4.40) weeks,which was lower than the Gamma group and the PFNA group(P<0.05); the weight-bearing time of the Gamma nail group was(14.06 ±4.91)weeks,which was obviously lower than that of the PFNA group(P<0.05). The fracture healing time and Harris score at 12 months after operation were not statistically significant among the three groups(P>0.05),and the incidence of the DHS group was 20.88%,which was significantly higher than that of the Gamma group and the PFNA group(P<0.05).Conclusion For the elderly patients with intertrochanteric fractures,Gamma nail,PFNA and DHS internal fixation can achieve satisfactory results.PFNA and Gamma nails are effective in shortening the operation and reducing the amount of bleeding in operation.DHS can make patients carry out early weight bearing training.The clinical selection should be based on the specific situation of the patients.
Keywords：intertrochanteric fracture of femurscrewinternal fixationelderly
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 336-340 )