Abstract:

Objective　To investigate the clinical effects of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) internal fixation in the treatment of intertrochanteric fracture in the elderly according to the anatomical features of type. 　Methods　From July 2013 to May 2015 the 92 cases of elderly patients with femoral intertrochanteric fracture were selected according to inclusion and exclusion criteria, all were treated by surgical treatment. According to the random number table and the different internal fixation they were divided into a PFNA group (44 cases), and a DHS group (48 cases). The changes and complications of the two groups were recorded and compared.　Results　The average radiation time was shorter and the occult blood loss less in the DHS group than in the PFNA group, while the average blood loss in PFNA group was less than that in the DHS group. There was no significant difference in the average operation time, length of stay, time of beginning getting out of bed and do movement, the time of fracture healing and the function of the hip joint function in the two groups (P>0.05). The incidence of  complications such as urinary tract infection, pulmonary infection, bedsore, deep venous thrombosis of lower limb(DVD), proximal screw head and neck incision, and coxavara rate difference was not statistically significant in two groups (P>0.05); The incidence of proximal screw withdrawal, pain in the lateral hip or thigh  was statistically significant (P<0.05).　Conclusions　PFNA or DHS internal fixation, each with its own advantages and disadvantages, should be selected according to fracture type of intertrochanteric fracture in the elderly. However, as long as effective fixation was achieved, early exercise can reduce complications, and the hip function in the affected side can recover well.

Key words: Femur;　Femoral intertrochanteric fracture;　Internal fracture fixation;　Osteoporosis; , Old