Therapeutic Effect of Artificial Femoral Head Replacement and Proximal Femoral Nail Antirotation on Elderly Unstable Intertrochanteric Fractures
- 1 Wuhan University of Science and Technology, Wuhan, China
- 2 China Resources Wuhan Iron & Steel General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- 3 China Resources Wuhan Iron & Steel General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- 4 China Resources Wuhan Iron & Steel General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
Abstract
Objective: To compare the clinical efficacy of artificial femoral head replacement and Proximal femoral nail antirotation (PFNA) in the treatment of unstable femoral intertrochanteric fractures in the elderly. Methods: This study retrospectively analyzed 60 elderly patients with unstable intertrochanteric fractures treated with PFNA and artificial femoral head replacement from 2015.06 to 2018.06, of which 34 were in the PFNA group (Group A) and 26 in the artificial femoral head replacement group (Group B). Statistical analysis of relevant surgical indicators such as surgical time, intraoperative blood loss, postoperative blood transfusion, postoperative time to landing, postoperative infection rate, hospital stay, number of secondary operations, postoperative VAS score, and postoperative Hip function score comparison. Results: All 60 patients were followed up for 1 - 24 months. Compared with the artificial femoral head replacement group, the operation time of PFNA group was shorter, the blood loss during operation was less, and the difference was statistically significant (P < 0.05). The postoperative blood transfusion volume, postoperative time, hospital stay, and postoperative time were higher in PFNA group. In the bone replacement group, the postoperative VAS score and the Harris score were lower than those in the artificial femoral head replacement group, and the differences were statistically significant (P < 0.05). There was no significant difference in the incidence of postoperative infection and the number of secondary operations between the two groups (P > 0.05). Conclusion: The hip joint function and pain scores of the artificial femoral head replacement group in the early and follow-up periods are better than those of the PFNA group. The artificial femoral head replacement is more suitable for the treatment of elderly unstable intertrochanteric fractures.
- Liu, M.F., Liu, G.H. and Shao, Z.W. (2017) Proximal Femoral Locking Plate for the Treatment of Elderly Unstable Inter-Trochanteric Fractures. Chinese Journal of Orthopaedics, 37, 1075-1080.
- Liu, G. and Jiang, X.Y. (2018) Selection of Internal Fixation for Unstable Intertrochanteric Fracture. Chinese Journal of Orthopaedics, 38, 1403-1412.
- Forte, M.L., Virnig, B.A., Swiontkowski, M.F., et al. (2010) Ninety-Day Mortality after Inter-Trochanteric Hip Fracture Does Provider Volume Matter. The Journal of Bone and Joint Surgery. American Volume, 92, 799-806. https://doi.org/10.2106/JBJS.H.01204
- Bonnaire, F., Straberger, C., Kieb, M., et al. (2012) Osteoporotic Fractures of the Proximal Femur. What’s New. Chirurgie, 83, 882-891. https://doi.org/10.1007/s00104-012-2340-8
- Petsatodis, G., Maliogas, G., Karikis, J., et al. (2014) External Fixation for Stable and Unstable Intertrochanteric Fractures in Patients Older than 75 Years of Age: A Prospective Comparative Study. Orthopaedics and Trauma, 25, 218-223. https://doi.org/10.1097/BOT.0b013e3181e9378a
- Dai, B., Meng, X.D. and Luo, H.T. (2010) Comparison of the Curative Effect of Three Surgical Methods in the Treatment of Elderly Femoral Intertrochanteric Fractures. Chinese Journal of Traumatology and Orthopaedics, 12, 688-690.
- Qian, J.F., Wang, D.Z. and Chen, J.W. (2019) Progress in the Treatment of Unstable Femoral Intertrochanteric Fractures in the Elderly. China Medical Journal of Metallurgical Industry, 36, 511-512.
- Dong, P.L., Tang, X.B. and Wang, J. (2016) Efficacy Analysis of Proximal Femoral Anti-Rotational Intramedullary Nails and Cemented Femoral Head Artificial Femoral Head Replacement for Elderly Femoral Intertrochanteric Fractures. Chinese Journal of Joint Surgery (Electronic Edition), 10, 37-42.
- Bu, Y., Zhao, K., Ma, S.Y. and Jiang, J.Z. (2015) Relationship between Intramedullary Nail Fixation and Perioperative Blood Loss in Intertrochanteric Fractures of Femur. Chinese Journal of Joint Surgery (Electronic Edition), No. 4, 459-462.
- Tang, C.Y., Chen, S., He, J.J., Xiang, Z., Liu, H., Ling, Y., Li, H.B., Zhou, X.C. and Li, Z.Y. (2017) A Clinical Comparison Study of PFNA Internal Fixation and Artificial Femoral Head Replacement in the Treatment of Elderly Unstable Intertrochanteric Fractures. Chinese Journal of Bone and Joint Injury, 32, 196-197.
- Ye, S.X., Fan, S. and Sun, P.D. (2013) A Finite Element Comparative Study of Evans-Jensen IIB Intertrochanteric Fractures with a New Anatomical Locking Plate for Proximal Femur. Chinese Journal of Orthopedic Surgery, 21, 2279-2285.