PFNA vs. DHS helical blade for elderly patients with osteoporotic femoral intertrochanteric fractures

H. Li, Q. Wang, G.-G. Dai, H. Peng

Department of Orthopedic, Renmin Hospital of Wuhan University, Wuhan, China. penghao5868@163.com

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• Orthopedics

OBJECTIVE: This study sought to compare the effects of proximal femoral nail anti-rotation (PFNA) and dynamic hip screw (DHS) helical blade treatments in patients with osteoporotic femoral intertrochanteric fractures.

PATIENTS AND METHODS: Eighty elderly osteoporosis patients with femoral intertrochanteric fracture complications admitted to the hospital between January 2013 and December 2014 were selected and divided into control (n=40) and observation (n=40) groups. The control group received DHS internal fixation while the observation group received PFNA treatment. Patients were followed up for 18 months, during which pre- and post-operative duration, Harris hip joint function scale, pain, bone mineral density and calcitonin level, 10 meter walking speed, five-fold-sit-to-stand test time, fracture healing and weight bearing time, and related complications were compared between groups.

RESULTS: Operational duration, hemorrhaging and drainage volume were all decreased in the observational group relative to the control group (p<0.05). Pre-operative Harris hip joint function scale scores were not significantly different between the two groups, but were superior in the observation group post-operation (p<0.05). A similar trend was observed for pain degree, bone mineral density and calcitonin levels, 10-meter walking speed, five-fold-sit-to-stand test time, and fracture and weight healing time (p<0.05). Complication incidence, such as coxa vara, loose nail, bone nonunion, delayed union of fracture, femoral head necrosis and deep venous thrombosis, etc., in the observation group was significantly lower than in the control group (p<0.05).

CONCLUSIONS: PFNA is characterized by minimal invasiveness, shorter time of operation, and accelerated post-operative recovery during the treatment of osteoporotic intertrochanteric fractures, and effectively improved patient bone density post-operatively, thus further promoting joint function recovery and reducing complication incidence.

Published on: 2018/07/11

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