Effects and safty evaluation of proximal femoral interlocking intramedullary nailing Ⅱ on imaging parameters and WOMAC score in treatment of femoral intertrochanteric fractures in the elderly

doi:10.3969/j.issn.1002-7386.2018.09.003

Abstract：Objective To investigate the effects of proximal femoral interlocking intramedullary nailing-Ⅱ (PFNA-Ⅱ) on imaging parameters and Western Ontario and McMaster Universities (WOMAC) score in treatment of femoral intertrochanteric fractures in the elderly, and to evaluate its safety.Methods A total of 120 elderly patients with femoral intertrochanteric fractures were divided into dynamic hip screw (DHS) group, proximal femoral locking plate (LPFP) group and proximal femoral interlocking intramedullary nailingⅡ(PFNA-Ⅱ) group according to random number table method,with 40 patients in each group. The imaging indexes including top distance,neck shaft angle and change rate of neck shaft angle >10°,hip joint WOMAC score of patients at 2m,4m,and 6m after treatment,and incidence of complications were observed and compared among the three groups.Results There were no significant differences in top distance and neck shaft angle among the three groups (P>0.05).At 6 months after operation, top the distance,neck shaft angle and change rate of neck shaft angle >10°in PFNA-Ⅱ group were significantly lower than those in DHS group and LPFP group (P<0.05).Moreover the top distance in DHS group and LPFP group at 6 months after operation was significantly higher than that after operation, however neck shaft angle was significantly lower than that after operation(P<0.05). There were no significant differences in top distance and neck shaft angle in PFNA-Ⅱ group between 6 months after operation and after operation (P >0.05), moreover there were no significant differences in hip joint WOMAC scores at 2 months after operation among the three groups (P>0.05).In addition the hip joint WOMAC scores at 4m and 6m after operation in PFNA-Ⅱgroup were significantly lower than those in DHS and LPFP groups,which in LPFP group at 6m after operation were significantly lower than those in DHS group (P<0.05).The hip joint WOMAC scores at 4 months after operation in the three groups were significantly lower than those at 2m after operation,which were significantly higher than those at 6 months after operation (P<0.05). Finally the incidence rate of complications in PFNA-Ⅱ group was significantly lower than that in DHS group and LPFP group (P <0.05). Conclusion PFNA-Ⅱ in treatment of femoral intertrochanteric fractures in the elderly can increase stability of fracture site,effectively decrease the changes of top distance and neck shaft angle, improve hip joint function and reduce incidence of complications.