Abstract:

BACKGROUND: The axis under stress of proximal femoral nail anti-rotation blade (PFNA) is inward shifted compared with dynamic hip screw (DHS), dynamic condylar screw (DCS), thereby increasing resistance to fatigue, with the support and the prevention of anti-varus rotation and thus less demanding on the stability of fractures. It has been used in unstable fracture.
OBJECTIVE: To evaluate the effect of PFNA in the treatment of the elderly osteoporotic femoral intertrochanteric fracture.
METHODS: A total of 44 cases of femoral intertrochanteric fracture treated by PFNA were retrospectively analyzed, including 20 males and 24 females aged 63-86 years. According to the Evans-Jensen classification, there were 3 cases of type Ⅱ, 8 of type Ⅲ, 10 of type Ⅳ, and 23 of type Ⅴ. The patients were followed up for 12 months. The incidence of postoperative complications, healing time and functional score were recorded.
RESULTS AND CONCLUSION: All the 44 patients obtained fracture healing in average of 5 months. No complications such as proximal femoral refracture, femoral head avascular necrosis, or stub nail, were detected, except for two cases of coax vara due to the early time weight-load. According to Harris hip score, the excellent and good rate was 96%. Results show that PFNA is an effective therapy for femoral intertrochanteric fracture, especially for comminuted fractures or the aged osteoporosis fractures. It has some advantages, minimal invasion, simple operation, solid internal fixation, and little bone loss.