A Comparative Study Of The Clinic Effects In The Treatment Of Senile Femoral Intertrochanteric Fracture With Proximal Femoral Nail Anti-rotation And Proximal Femur Locking Plate

ObjectiveTo compare the effects of proximal femoral nail anti-rotation and proximal femurlocking plate in treating Senile Femoral Intertrochanteric Fracture and to provide referencefor choosing the proper method for intertrochanteric fractures and future research.MethodThe researcher chose his research object from the patients treated with PFNA andPFLP in Department of Orthopaedics Xiangcheng People’s Hospital for femoralintertrochanteric fracture. According to the integration and elimination standard,172patients were incorporated. With the14cases out of the follow-up being excluded that therate of out of the follow-up is8.05%,158patients were included in the final comparison.PFNA group:80cases—27male cases and53female cases. These patients are agedbetween61and98, and the average age of them is79.96. AO typing: A1typing—19cases;A2typing—51cases; A3typing—10cases. PFLP group:78cases—20male cases and58female cases. These patients are aged between63and92, and the average age of them is77.96. AO typing: A1typing—17cases; A2typing—40cases; A3typing—21cases.Statistic analysis of the two groups in terms of the general preoperative was of nostatistical significance.(p>0.05), which was comparable. This research mainly made acomparison of the patients from tow groups in two aspects.⑴Clinic Effects: It includes therecord of the respectively operative time，blood loss，the average hospitalization time, theaverage postoperative down time, Perioperative hemoglobin lost on average, the complication, fracture healing time，and Harris score of the two groups of patients.⑵Radiographic Assessment: It includes the X ray film to evaluate fracture, ununited fracture,internal fixation failure and the remained deformity.ResultPFNA group: operation time:45~70min, mean operation time:55.16±4.87min;intraoperative blood loss:50~100ml, mean intraoperative blood loss:78.88±11.5ml; theamount that hemoglobin dropped before and after operation:(one day preoperative andpostoperative review contrast)19~32g/L, mean amount:25.2±2.57g/L; intraoperativefluoroscopy time:18~24sec， mean intraoperative fluoroscopy time20.37±1.52sec;hospitalization time:6~16days, mean hospitalization time:10.28±2.42days; thepostoperative down time:10~27days, the mean postoperative down time:16.38±2.98days;fracture healing time:12~14weeks, the mean fracture healing time:13.1±0.59weeks; thelast follow-up visit Harris score:90~94, the average last follow-up visit Harris score:92.15±1.04.PFLP group: operation time:50~90min, mean operation time:65.83±7.32min;intraoperative blood loss:200~450ml, mean intraoperative blood loss:350.64±63.56ml;the amount that hemoglobin dropped before and after operation:(one day preoperative andpostoperative review contrast)20~36g/L, mean amount:29.36±3.43g/L; intraoperativefluoroscopy time:8~14sec， mean intraoperative fluoroscopy time11.99±1.50sec;hospitalization time:13~27days, mean hospitalization time:19.74±2.95days; thepostoperative down time:20~48days, the mean postoperative down time:31.51±3.96days;fracture healing time:13~30weeks, the mean fracture healing time:15.2±2.53weeks; thelast follow-up visit Harris score:88-94, the average last follow-up visit Harris score:92.06±1.06. the respectively operative time，blood loss. The differences of the averagehospitalization time, the average postoperative down time, Perioperative hemoglobin loston average, the complication, fracture healing time，and the mean ADL of the two groupsof patients are of statistical significance.(P﹤0.05). However, the differences of the lastfollow-up visit Harris score of the two groups of patients of no statistical significance. (p>0.05)ConclusionPFNA and PFLP are both the effective methods to cure Senile FemoralIntertrochanteric Fracture. What’s more, there are many advantages in PFNA, such asshorter operation time, shorter hospitalization days, less intraoperative and the generalblood loss, earlier ambulation and shorter fracture healing time, which can be a goodoperation method to treat Senile Femoral Intertrochanteric Fracture. However, there alsoexit some disadvantages—longer intraoperative fluoroscopy time. So attention should bepaid to protecting the related personnel.