Comparison of effects between artificial joint replacement and proximal femoral nail anti-rotation for treatment of unstable intertrochanteric femoral fracture in elderly patients
10.3969/j.issn.2095-4344.0031
- VernacularTitle:人工关节置换与股骨近端髓内钉治疗高龄不稳定股骨转子间骨折的对照
- Author:
Tian LAN
1
;
Zhan SHAN
;
Jin-Chun WU
Author Information
1. 武警广东省总队医院外二科
- From:
Chinese Journal of Tissue Engineering Research
2018;22(3):362-367
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Both proximal femoral nail anti-rotation (PFNA) and joint replacement in treatment of intertrochanteric femoral fracture can guarantee early bed removal and reduce long-term bed complications, but there are still more controversies in the selection of indications for the two methods.OBJECTIVE: To observe the differences in clinical effects of artificial joint replacement and PFNA in treatment of unstable intertrochanteric femoral fracture in elderly. METHODS: Totally 56 patients with Evans-Jensen types III-V intertrochanteric femoral fracture aged older than 65 years were enrolled in this study. Follow-up was conducted for 12 months. 11 cases did not complete follow-up visit. Among the remaining 45 cases, 27 patients were treated with artificial joint replacement, and 18 patients were treated with PFNA. Operation time, intraoperative blood loss, and postoperative weight-bearing time were compared between the two groups. Postoperative hip function was compared using Harris score between both groups. Postoperative complications were evaluated by clinical and radiological manifestations in both groups within 1 year after surgery. RESULTS AND CONCLUSION: (1) Operation time and postoperative weight-bearing time were shorter in artificial joint replacement group than in the PFNA group (t=5.596, t=14.142, P < 0.05). (2) At postoperative 1, 3 and 6 months, Harris score was significantly higher in the artificial joint replacement group than in the PFNA group (t=8.301, t=10.017, t=8.593, P < 0.05). Harris score was similar between the two groups at postoperative 1 year (t=1.541, P > 0.05). (3) The total incidence of complications was 22% in artificial joint replacement group and 23% in PFNA group; there were no statistical differences between the two groups (χ2=0.180, P > 0.05). (4) For elderly patients with unstable intertrochanteric femoral fracture, artificial joint replacement and PFNA can obtain satisfactory effect. The operation time of artificial joint replacement is short, and early weight-bearing contributes to reducing long-term bed complications.
