Clinical study of two methods of internal fixation for intertrochanteric fractures

Abstract

Objective To explore the clinical efficacy and analyse the complications of proximal femoral nail antirotation(PFNA) and dynamic hip screw(DHS) in the internal fixation for intertrochanteric fractures of femur. Methods Sixty cases of intertrochanteric fracture of femur were included in this study. They were all treated in the Affiliated Hospital of Southern Universtiy of Science and Technology from January 2017 to January 2019. They were divided randomly into DHS group (n=30) and PFNA group (n=30) according to random number table method. Both groups were given routine preoperative preparation and postoperative treatment, DHS group were treated with DHS internal fixation, PFNA group were treated with PFNA internal fixation. The discharged patients were followed up for half a year. The difference of surgical indicators between the two groups, and the complications of the two groups were compared. Half a year after discharge, the fracture healing indicators and the Harris scores were also compared. Chi-square test and t test were used for analysis. Results The operation time, bleeding volume and incision length of PFNA group were shorter than or less than those of DHS group (t=3.029, 9.416, 8.945, all P<0.01). Half a year after discharge, the fracture healing time and weight-bearing time of PFNA group were shorter than those of DHS group (t=2.118, 3.227, both P<0.05). The total Harris scores of PFNA group and DHS group were higher than those of DHS group half a year after discharge, and PFNA group were higher than that of DHS group, the difference was statistically significant (t=2.485, P<0.05). Postoperative complications were both 10% in PFNA group and DHS group. Conclusions PFNA and DHS can treat intertrochanteric fractures of femur. PFNA internal fixation has obvious advantages over DHS, which shows shorter operation time, less bleeding, less trauma, higher healing rate and higher Harris score and improves the limb function. Key words: Hip fractures; Fracture fixation, intramedullary; Bone screws