Comparison of three fixations for treatment of intertrochanteric femoral fractures in the elderly

Objective:To compare the clinical effects of three internal fixations as follows:dynamic hip screw (DHS), proximal femoral nail-A (PFNA) and InterTAN,for intertrochanteric femoral fractures in elderly patients. Methods:From February 2007 to May 2012,136 elderly patients with intertrochanteric fractures (including 71 males and 65 females,ranging in age from 60 to 88 years old with an average of 69 years old) were treated with DHS (group A,80 cases),PFNA (group B,36 cases) and InterTAN (group C,20 cases). Statistical analysis were applied to compare the 3 groups in operative time,blood loss,fracture healing time,intrraoperative complications and functional outcome (Harris hip score). Results:The average follow-up was 4.1 months (from 2.5 to 14 months). Compared with group A,groups B and C showed significant advantages in operative time,blood loss,fracture healing time,and intrraoperative complications,functional outcome (Harris scores) (P0.05). Compared with group B,group C had significant fewer intrraoperative complications (P0.05). There were no significant differences in all the indexes except intrraoperative complications between groups B and C (P0.05). Conclusion:The PFNA and InterTAN appear to be more reliable than DHS for the treatment of intertrochanteric femoral fractures in the elderly ,but InterTAN appear to be more reliable in comminuted and complex intertrochanteric femoral fractures in the elderly than PFNA.