Abstract:

BACKGROUND: Treatments for intertrochanteric fractures have three methods: dynamic hip screw (DHS), Gamma nail and proximal femoral nail anti-rotation (PFNA). Which one is more safe, effective, and reliable is still controversial.
OBJECTIVE: To explore the clinical efficacy of three different internal fixation methods on elderly intertrochanteric fractures.
METHODS: According to the different surgical methods, 90 elderly patients with intertrochanteric fractures were divided into PFNA group, Gamma nail group and the DHS group. A comparison among the three groups in operative time, blood loss, hospital stay, fractures healing and surgical complications was performed.
RESULTS AND CONCLUSION: Totally 90 patients were followed for 12-26 months. The total efficiency of the PFNA group was higher than that of the DHS group and the Gamma nail group, but no significant difference existed (P > 0.05). In the PFNA group, the operation time, blood loss and hospital stay were significantly shorter than those in the DHS group and the Gamma nail group (P < 0.05). Although in the PFNA group the callus formed earlier and fracture healing time were shorter than those in the DHS group and the Gamma nail group, there was no significant difference (P > 0. 05). The incidence of postoperative complications during the follow-up was lower in the PFNA group than the DHS group and the Gamma nail group (P < 0.05). PFNA method compromises less vascular support and osseous, and provides more stable fixation, which is a reasonable surgical method for intertorchanteric fractures.