Clinical Results Of PFNA And DHS In The Treatment Of Inter-trochanteric Fracture

Objective: To compare the radiological and clinical efficacy in patients ofinter-trochanteric fracture (inter-trochanteric fracture, ITF) by follow-up study with the useof proximal femur nail anti-rotation(PFNA) and dynamic hip screw (DHS),and summarizethe advantages and disadvantages of these two different fixator. Provide clinical evidencein fixation devices selecting.Methods: we retrospectively reviewed140inter-trochanteric fracture patients sinceJanuary2010to January2013at the First Affiliated Hospital of Soochow University andPeople’s Hospital of Xiang Cheng district Suzhou City. And the patients were divided intotwo groups according to fixation devices selecting: PFNA group and DHS group.According to the inclusion criteria, a total of140cases(146hips) received completefollow-up. PFNA group of70patients (74hips), including33males and37females,aged67to93years (76.24±6.17); DHS group of70patients (72hips), including32males and38females, aged65to87years (75.20±5.78). PFNA group using proximalfemoral nail anti-rotation (proximal femoral nail anti-rotation, PFNA)28hips and usingAsian hip (PFNA-II)46hip. All DHS group using dynamic hip screw (DHS).(1)Clinical aspects: respectively, from the operative time, intra-operative blood loss, theaverage length of hospital stay, postoperative ambulation time, postoperative complications, healing time, and other aspects of Compare use Harris score for patients with functionalscores;(2) imaging, through preoperative and postoperative X-rays taken on patientsfractures, TAD(tip-apex distance), with or without bone nonunion, with or without internalfixation failure, with or without residual deformity were evaluated.Results: The study included patients were complete followed for an average of8to16months, no case of neurovascular injury, fracture healing in all patients. PFNA group andDHS group in operative time, intro-operative blood loss, the average length of hospital stay,postoperative ambulation time, postoperative complications were significantly different (P<0.05). The two groups in fracture healing time, TAD values, Harris score and clinicalaspects of satisfaction were no significant differences (P>0.05).Conclusion: In the treatment of inter-trochanteric fractures, PFNA is superior to DHS inoperative time, intro-operative blood loss, average length of stay, postoperative ambulationtime, postoperative complications, healing time, but there is little difference between thesetwo group in functional recovery. Comprehensive view, PFNA led less tissue trauma, lessbleeding, reliable fixation is the treatment of inter-trochanteric fracture fixation. Cliniciansshould be based on the patient’s condition, and other factors to select individualrequirements.