Comparison of hidden blood loss and prognosis between two types of internal fixation in the treatment of intertrochanteric fractures among the elderly

HUANG Kai; CHEN Anfu

Abstract：[Abstrac] ObjectiveTo compare the effectiveness of dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA) in the treatment of intertrochanteric fractures among the elderly.MethodsDate on 68 elderly patients with intertrochanteric fractures who had been treated in the Department of Orthopaedics at our hospital were collected, including 32 cases who had undergone DHS internal fixation (DHS group) and 36 cases who had received PFNA internal fixation (PFNA group).All the patients completed 1-year follow-up after surgery.The operation time, length of hospital stay, postoperative total weight bearing time, fracture healing time and hidden blood loss in the two groups were statistically analyzed.Changes of hip function were monitored and prognosis was compared between the two groups.Results ①The total effective rate was 93.75% in DHS group and 94.44% (P>0.05) in PFNA group;②the operation time, length of hospital stay, total weight bearing time and fracture healing time was shorter in PENA group than in DHS group (P<0.05);③on postoperative 1, 2~3 d and 4~5 d, the hidden blood loss of PFNA group was less than that of DHS group (P<0.05);④after surgery, Harris scores of the two groups were higher than those before surgery (P<0.05). the increasing amplitude of scores in PFNA group 3, 6, 12 months after surgery was greater than that in DHS group (P<0.05);⑤3, 6, 12 months after surgery, activities of daily living (ADL) scores of PFNA group were higher than those of DHS group (P<0.05).ConclusionThe overall effect of PFNA internal fixation in the treatment of intertrochanteric fractures among the elderly is good. The hidden blood loss of patients is little and postoperative hip function recovery is fast, with good prognosis.