Abstract:

BACKGROUND: There are two main fixation methods for the treatment of intertrochanteric fractures, one is the extramedullary fixation screw-plate system which represented by the dynamic hip screw (DHS), and another one is the intramedullary fixation nail system which represented by the proximal femoral nail antirotation (PFNA). 
OBJECTIVE: To compare the effect of PFNA and DHS in treatment of intertrochanteric fracture in old people. 
METHODS: In this retrospective study, a series of 58 patients with intertrochanteric hip fractures were reviewed from January 2008 to December 2010 in the Department of Orthopedics, Shanxi Provincial People’s Hospital. The patients were treated with PFNA and DHS respectively.
RESULTS AND CONCLUSION: The mean follow-up time was 13 months in DHS group and 11 months in PFNA group, and all the patients in the two groups achieved bone healing. The full weight-bearing time and the fracture healing time in DHS group were longer than those in the PFNA group (P < 0.05); there was no significant difference of the Parker-Palmer’s score in two groups (P > 0.05). And in the DHS group, nail loose occurred in 1 case, plate fracture in 1 case; all patients were ultimately healed without wound infection, internal fixation cutting, coxa vara and other complications. For the treatment of intertrochanteric femoral fracture, both DHS and PFNA fixation could achieve a good outcome, however, the patients in PFNA fixation group get full weight-bearing stepping and fracture healing earlier than the ones of DHS fixation group.