A Comparative Study Of Proximal Femoral Nail Anti-rotation And Proximal Femoral Locking Plate In The Treatment Of Intertrochanteric Fracture Of Femur With Lateral Wall Risk

Objective: To compare and analyze the clinical effects of proximal femoral nail anti-rotation(PFNA)and proximal femoral locking plate(PFLP)in the treatment of intertrochanteric fracture of femur with lateral wall risk.Method: From January 2015 to January 2017,patients in the treatment of intertrochanteric fracture of femur were retrospectively analyzed in Bengbu NO.3people’s hospital.Through inclusion,exclusion criteria and therapy methods,70 patients included in this study with intertrochanteric fracture of femur with lateral wall risk were treated by either PFNA or PFLP.These patients were divided into two groups according to different surgical methods.PFNA group is 38 patients and PFLP group is 32 patients.Compare and analyze general datas(sex,age,fracture side,BMI,AO type of fracture,ASA classification,time from injury to operation),preoperative datas(reduction quality,incision length,operative time,blood loss,and the number of every intra-and post-operative complication)and the follow-up datas after leaving hospital(the number of every complication,Harris hip score of last time and the number of deaths).Results: Among the 70 cases of patients were followed-up for 6~12 months,averaged11.7 months.The general datas(sex,age,fracture side,BMI,AO type of fracture,ASA classification and time from injury to operation)were compared between the PFNA group and PFLP group: There were no significant differences between these two groups(P > 0.05).There were no significant differences between two groups in fracture reduction quality(P>0.05).Compared with PFLP group,PFNA group has a smaller incision length and shorter operation time.There were significant differences between these two groups(P < 0.05).In terms of blood loss,Compared with PFLPgroup,PFNA group has less dominant blood loss and more hidden blood loss.There were significant differences between these two groups(P < 0.05).There were no significant differences between two groups in total blood loss(P>0.05).The numbers of intra-and post-operative complications(intraoperative fracture,incision complication,deep venous thrombosis,pneumonia and delirium)were compared between the PFNA group and PFLP group: There were no significant differences between these two groups(P>0.05).The numbers of every complication after leaving hospital(coxa deformity,cutting-out of screw,internal fixation breakage,hip pain),Harris hip score and the number of deaths were compared between the PFNA group and PFLP group: There were no significant differences between these two groups(P>0.05).Conclusion: Both PFNA and PFLP have good effectiveness in the treatment of intertrochanteric fracture of femur with lateral wall risk.And there are many advantages in PFNA,such as smaller incision length,shorter operation time.Whatever internal fixation is selected,protecting lateral wall,satisfactory reduction,correct operation and reasonable functional training are important to get good prognosis.