A Comparison of Two kinds of Operatiion in Treatment of Elderly Evans Type Ic Intertrochanteric Fractures

SI Feng

Abstract：Objective To compare treatment effects between artificial femoral head replacement and proximal femoral nail anti_rotation(PFNA)in the elderly Evans type Ic femoral intertrochanteric fractures. Methods From January 2010 to July 2012,there were 48 elderly patients who had suffered from Evans type Ic femoral intertrochanteric fractures,which were retro_spectively analyzed based on operative management. PFNA for 21 cases and artificial femoral head replacement for 24 cases. The clinical results of the 2 groups were documented and compared in the followed aspects:operation time,blood loss during operation,load bearing time,incidence rates of complications and the Harris hip score of 3 and 12 months after operation. Re_sults There were 43 patients got follow_up,2 cases were lost,with average follow_up time was 16. 1 months. There were 3 pa_tients who failed with PFNA internal fixation were treated with artificial femoral head replacement. Follow_ups showed that PF_NA group was superior to artificial femoral head replacement group in the operation duration and the blood loss during operation (P < 0. 05),and inferior to artificial femoral head replacement group in the load bearing time and the Harris hip score at the time 3 months after operation(P < 0. 05),There were no significant difference in the incidence rates of complications and the Harris hip score at the time 12 months between two groups(P > 0. 05). Conclusion PFNA can be preferred to apply in the elderly Evans Ic femoral intertrochanteric fractures,but to severe osteoporosis or internal fixation failure,the artificial femoral head replacement is better.