Abstract: BACKGROUND: Proximal femoral antirotation intramedullary nailing is currently the preferred internal fixator for the treatment of intertrochanteric fractures of the femur. The use of different types of tail caps in non-anatomical reduction may have an impact on the surgical efficacy.  
OBJECTIVE: To investigate the clinical effect of proximal sliding compression technique in the treatment of elderly intertrochanteric fractures of the femur with proximal femoral nail antirotation internal fixation and positive supportive reduction.
METHODS:  Clinical data of 76 cases of elderly intertrochanteric fractures of the femur, who were treated in Department of Orthopedics and Traumatology, the Third Affiliated Hospital of Anhui Medical University (the First People’s Hospital) from August 2016 to August 2019 using proximal femoral nail antirotation treatment and positive support in intraoperative reduction, were retrospectively analyzed. The patients were divided into two groups according to the presence and absence of proximal sliding compression technology. The 42 cases in the sliding compression group received sliding compression technique at the proximal end. The 34 cases in the non-sliding pressure group received conventional treatment at the proximal end. Operation time, intraoperative blood loss, changes in femoral neck length immediately and 6 months after surgery, tip-apex distance change, fracture healing time, incidence of postoperative complications, and hip Harris function score were compared between the two groups at 1 year after surgery.  
RESULTS AND CONCLUSION: (1) There was no significant difference between the two groups in gender, age, side, cause of injury, fracture type and other general data (P > 0.05), and the data of the two groups were comparable. (2) There were no significant differences between the sliding pressure group and the non-sliding pressure group in operation time, intraoperative blood loss, changes in femoral neck length immediately and 6 months after surgery, tip-apex distance change, postoperative complication rate, and hip joint Harris function score at 1 year after surgery (P > 0.05). (3) However, the fracture healing time [(6.79±0.81) weeks] in the sliding pressure group was significantly shorter than that of the non-sliding pressure group [(7.88±1.07) weeks], with a significant difference (P < 0.05). (4) It was suggested that proximal femoral nail antirotation internal fixation should be applied to the treatment of senile intertrochanteric fractures. When anatomical reduction cannot be achieved, the medial cortex should strive to achieve positive supportive reduction, and the proximal application of sliding compression technology can significantly shorten the fracture healing time.

Key words: intertrochanteric fracture, proximal femoral nail antiratation, positive support, sliding compression, femur neck, tip-apex distance