Comparison of hemiarthroplasty and PFN fixation for the treatment of unstable intertrochanteric hip fractures in senile patients.

[Objective]To discuss a reasonable treatment for unstable intertrochanteric hip fractures in senile patients by comparing the effects of PFN fixation and hemiarthroplasty.[Method]Totally 82 intertrochanteric hip fractures in senile patients with complete clinical data were retrospectively analyzed,who were treated with hemiarthroplasty or PFN fixation from April 2005 to April 2007.Forty-six were treated with hemiarthroplasty,36 were treated with PFN fixation.All of them had multiple medical co-morbidities.According to modified Evens-Jensen classification,all of them belonged to unstable fracture.Comparison was made between the two treated groups in terms of the length of incision,operative time,the blood lost,blood transfusion during or after surgery,time for bed rest postoperatively,postoperative complications and St.Michael hip score one year after surgery.[Result]The average duration of follow-up for PFN fixation and hemiarthroplasty were 16 and 18 months respectively.Compared with the group of hemiarthroplasty,the group of PFN fixation experienced longer operation time,longer time for bed rest postoperatively,less blood lost,less blood transfusion during or after surgery,shorter incision length,and the differences between two groups had statistical significance (P0.05).Whereas the differences in the postoperative internal medicine complications and the postoperative implant complications,St.Michael hip score one year after surgery between two groups had of no statistical significance(P0.05).[Conclusion]Both of the two methods are reasonable treatment for unstable intertrochanteric hip fractures in senile patients.