Effect Comparison Of Proximal Femoral Nail Antirotation(PFNA) And Dynamic Condylar Screw(DCS) In The Treatment Of Elderly Patients With Instability Intertrochanteric Fracture(IF)

Objective:To compare the operation outcomes of Proximal Femoral Nail Antirotation(PFNA)with Dynamic Condylar Screw(DCS)for the elderly patients with instability intertrochanteric fracture.Methods:A retrospective study was performed in the 150 th Central Hospital of the Peoples liberation army,66 eligible patients with instability intertrochanteric fracture given PFNA or DCS treatment were enrolled from June 2012 to June 2014,29 males and 37 females,aged 65-90 years,mean age 76.1 years.32 of them were treated with the PFNA(15 males and 17 females),and 34 cases with DCS(14 males and 20 females).The mean follow-up time was 2 years.The AO fracture classification,injury-admission time,injury-surgery time,anesthesia methods,hospital stays,operative time,intraoperative blood loss,restoration quality of immediate postoperative,part weight-bearing time,Harris hip function score,1 year mortality and postoperative complications were compared between the two group.Results:There were no significant difference between the two group about the AO fracture classification,injury-admission time,injury-surgery time,anesthesia methods,hospital stays,restoration quality of immediate postoperative,postoperative complications and 1 year mortality(P(29)0.05).In term of average surgical time,intraoperative blood loss and part weight-bearing time,it was significantly lower in PFNA group than DCS group(P(27)0.01).There were no significant difference between the two groups in function,malformation and range of motion in Harris hip function scores(P(29)0.05),but the pain of Harris hip function score were better in the PFNA group(38.38 ± 8.78)than in the DCS group(32.29 ± 10.14)(P<0.05).Conclusion:Compared with DCS,1.because of shorter surgical time and less operative blood,PFNA could shorten anesthesia time and reduce the second-hit phenomena and adverse effects anesthesia;2.earlier weight-bearing in PFNA could reduce complications caused by the long-term bed rest and improve patients balance without compromising fracture healing;3.patients underwent PFNA could achieve better recovery of hip function in patients,improve quality of patients' life and be satisfied with efficacy of treatment.Therefore,PFNA may be a better option for elderly patients with instability intertrochanteric fracture.