摘要
Abstract
Objective : To compare the clinical effects of PFNA and InterTAN for the treatment of unstable in-tertrochanteric fractures in the elderly patients. Methods : From April 2012 to February 2014 , 113 elderly patients with unstable intertrochanteric fractures were treated by PFNA or InterTAN. There were 64 cases in PFNA group , including 25 males and 39 females with an average age of (73.3±6.5) years old (ranged , 66 to 85) ; while 49 cases in InterTAN group , including 20 males and 29 females with an average age of (74.2±5.4) years old (ranged ,65 to 85). According to the AO classification , there were 48 cases of type A2 , 16 cases of type A3 in PFNA group and 37 cases of type A2 , 12 cases with type A3 in InterTAN group. The time interval from injury ranged from 3 to 8 days with an average of 4.7±1.2. The blood loss , operation time, fluo-roscopy time , lateral cortex fractures of the proximal femur , healing time of fracture , femoral shaft fractures , femoral head screw cut-out , necrosis of the femoral head , femoral neck shortening and Harris score of patients at the last follow-up were compared between the two groups. Results:Fifty-eight patients in PFNA and 44 patients in InterTAN were followed up for 14 to 18 months with an average of 16.3 ±1.2. Wound healing was satisfying during the follow-up. Significant differences were observed between the two groups regarding the blood loss , operation time, fluo-roscopy time. The complication rate of femoral shaft frac-tures,femoral head screw cut-out and femoral neck shortening in InterTAN group was less than that in PFNA group , showing significant difference between the two groups (P<0.05). At the latest follow-up , the average Harris scores were 90.7±5.1 in PF-NA group and 90.4±3.9 in InterTAN group , there was no significant difference between the two groups (P>0.05). Conclusion: InterTAN with stronger anti-rotation function is more suitable for patients with early weight-bearing and it reduces the incidence rates of hip varus , femoral head screw cut-out and femoral neck shortening. However ,for those patients with osteoporosis or un-fit for surgery , PFNA is a good option. As the limited follow-up duration , long-term effects of the two surgical methods needs to be further observed and studied.关键词
股骨骨折/骨折固定术,内/病例对照研究Key words
Femoral fractures/Fracture fixation/internal/Case-control studies
