Comparative study on the repair of femoral intertrochanteric fracture in elderly patients with nail plate fixation, PFNA nail and artificial femoral head replacement

Objective To compare the clinical results of the treatment of intertrochanteric fractures in the elderly with the fixation of the nail plate, PFNA nail and artificial femoral head replacement. Methods One hundred and twenty-six elderly patients with intertrochanteric fracture from June 2012 to January 2016 were selected. According to the different surgical methods, they were divided into group A(n=42), group B(n=42), group C(n=42). The group A was treated with proximal femoral anatomical plate, the group B was treated with PFNA nail fixation, and group C was treated with artificial femoral head replacement. The clinical efficacy and complications were compared, and the relative indexes were compared. Results The excellent rate(90.48%) of group A, excellent rate of group B(90.48%) and excellent rate(88.10%) of group C had no significant difference (P>0.05); the surgery time in group B was(68.11±13.25) min, intraoperative blood loss(133.17±28.36) ml; which were significantly less than those in the group A, group C. In group C, the lower loading time[(10.23±2.17) d] was significantly less than that in group A[(34.16±7.51) d] and group B[(30.88±5.97) d], and the differences were significant(P<0.05). The incidence of complications(28.56%) in group A was significantly higher than that in group B(9.52%) and group C(11.90%), and the differences were significant(P<0.05). Conclusions Nail plate fixation, PFNA nail and artificial femoral head replacement in the treatment of femoral intertrochanteric fractures in the elderly can achieve significant therapeutic effect, each of the three methods has its advantages and disadvantages, and the choice of the best operation method is to consider the age of the patient, the classification of the fracture and the tolerance of the body. Key words: Nail plate fixation; PFNA nail; Artificial femoral head replacement; Femoral intertrochanteric fracture in the elderly