Clinical efficacy of two internal fixation methods in treatment of intertrochanteric fracture of femur in elderly patients

Abstract

Objective To compare the clinical effectiveness of reverse less invasive stabilization system(LISS) and proximal femoral nail anti-rotation(PFNA) in treatment of intertrochanteric fracture in aged, and to investigate the selective strategy of the internal fixation. Methods From September 2009 to September 2017, 78 consecutive patients with intertrochanteric fracture, who had gone through LISS or PFNA, followed by at least 12-month follow-up and complete imaging follow-up and clinical examination were included in this study, and those who don’t meet the inclusion criteria would be excluded. Among them, 42 patients were treated by LISS, including 20 males and 22 females, mean age (73±16)years; 36 patients were treated by PFNA, including 16 males and 20 females, mean age (74±10) years. The mean intraoperative time, length of incision, intraoperative blood loss, length of hospitalization, time of starting weight loading, time of fracture healing, hip function (Harris score), general complications, fracture complications between the two groups were analyzed and compared through t test or Chi-square test. Results All the patients were evaluated with a follow-up time of 22(19, 29) months. No statistical difference in intraoperative blood loss, length of hospitalization, time of starting weight loading, time of fracture healing, hip function (Harris score), general complications, fracture complications could be founded between the two groups. The mean intraoperative time(t=0.850, P<0.05) and length of incision(t=-2.600, P<0.05)were longer in the LISS group than the PFNA group. Conclusion No difference in the outcome or complication between LISS and PFNA, while PFNA has simpler operation steps, shorter intraoperative time and less trauma, which is more suitable for the patients with complicated condition and relatively elder age. Key words: Hip fractures; Internal fixators; Aged; Minimally invasive surgical procedures