Comparison Of The Efficacy Of Artificial Femoral Head Replacement And PFNA In The Treatment Of Unstable Intertrochanteric Fractures In The Elderly

Objectives: To compare the efficacy of artificial femoral head replacement and anti rotation proximal femoral nail(PFNA) internal fixation in the treatment of unstable intertrochanteric fractures in elderly patients.Methods: 70 cases of unstable intertrochanteric fractures were selected from the Affiliated Hospital of Hebei University from September,2013 to September,2015. All the patients were treated with limb skin traction before operations, and perfected the related preoperative examinations, and actively dealed with complications. Patients were divided into two groups:the artificial femoral head replacement group and the PFNA group and there were35 cases in each group. Ages, genders, general physical conditions, fracture types,intr AO/ASIFperative bleeding volume, operation times, times of lying in bed, incidence and mortality of venous thrombosis in postoperative patients were recorded and compared.General conditions, times of recovery, postoperative complications and hip joint functions in postoperative patients were followed up and incidences of postoperative complications and hip function scores after operations in the two groups were compared.Result:(1) The numbers of female patients are larger than those of males in the both two groups, but gender differences between the two groups had no statistical significance(P>0.05);(2) There are no statistical significances in the aspects including age, preoperative complications, type of fracture, and hip function scores after 6 months of operations(P>0.05);(3) Times of lying in bed, times of recovery, postoperative 1, 3 months of hip joint function evaluation,incidence of venous thrombosis in postoperative patients, medical comorbidity rate and mortality in the Artificial femoral head replacement group were better than those in the PFNA group and the differences were statistically significant(P < 0.05);(4) The total cost during hospitalization,operation time and intr AO/ASIFperative bleeding volume in the PFNA group were better than those in the other group and the differences were statistically significant(P < 0.05).Conclusions:(1) The incidence of women is higher than that of men in the elderly patients with intertrochanteric fractures;(2)Compared with the Artificial femoral head replacement group,surgery time is shorter,intr AO/ASIFperative bleeding volume is smaller and cost is lower in the PFNA group, so PFNA is a good choice for those patients or family whose tolerance to surgery and economic conditions are poor;(3)Because operation time is long,surgery is difficult and intr AO/ASIFperative bleeding volume is large for unstable intertrochanteric fracture of the joint replacement,the choice of surgical approach should be taken into account a variety of factors in order to enable patients to achieve the greatest clinical benefit;(4) Artificial femoral head joint replacement is conducive to the early recovery of patients after operation, and it can reduce venous thrombosis and postoperative complications and mortality and improve the quality of life of patients, so it can be regarded as a kind of method which can be further studied.