CLINICAL EFFICACY AND SAFETY OF PFNA AND DHS IN THE TREATMENT OF UNSTABLE INTERTROCHANTERIC FRACTURES IN ELDERLY PATIENTS

Chengxiang Han, Xiaofang Song, Yejie Huang, Guangzhi Yang^*

Department of Orthopedics, The Affiliated Lianyungang Oriental Hospital of Xuzhou Medical University, Lianyungang, Jiangsu Province, China

Objective: This study was designed to explore the clinical efficacy and safety of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in the treatment of unstable intertrochanteric fractures in elderly patients. 

Methods: A total of 130 elderly patients with unstable intertrochanteric fractures admitted to our hospital from January 2016 to September 2019 were enrolled, and assigned to an observation group (n=80) and a control group (n=50) according to different treatment methods. Patients in the observation group were treated with PFNA, while those in the control group were treated with DHS. The operation situation, pressure injury, visual analog scale (VAS) score, injury area, neurological function, and limb function of the two groups were evaluated, and the complication rate, recovery, and treatment satisfaction of them were investigated. 

Results: Compared with the control group, the observation group experienced shorter operation time and fracture healing time and less intraoperative blood loss, and suffered a shorter incision. In addition, compared with the control group, there were less patients with pressure injury in the observation group, and the observation group showed smaller injury area, got lower VAS score, higher American spinal injury association (ASIA) motor score, and Fugl-Meyer Assessment (FMA) score, and showed higher Barthel index, lower complication rate, better recovery, and higher treatment satisfaction. 

Conclusion: PFNA is more effective and safer in the treatment of elderly patients with unstable intertrochanteric fractures.