The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Proximal femoral nail anti- rotation versus dynamic hip screw for femoral intertrochanteric fracture

Author : WANG Yan, WANG Hai-bin, SHI Fajian, WANG Bin, ZHANG Lei, DING Zhi-yong.     
Working unit : Department of Orthopedics, Nanjing Jiangbei People's Hospital Affiliated to Nantong University, Nanjing 210048, China
Page : 2223-2227.
Key words : intertrochanteric fracture, proximal femoral nail anti-rotation (PFNA) , dynamic hip screw (DHS) , internal fixation
Abstract: [Objective] To compare the clinical outcomes of proximal femoral nail anti-rotation (PFNA) versus dynamic hip screw (DHS) for femoral intertrochanteric fractures. [Methods] A total of 100 patients who were admitted into our hospital fromJuly 2014 to July 2018 for femoral intertrochanteric fractures were enrolled into this study, and divided into two groups by random number table method with 50 patients in each group. The patients in the PFNA group had the fractures fixed by using PFNA, while those in the DHS group were by using DHS. The clinical data was compared between two groups. [Results] All the patients had surgical procedure performed smoothly without serious complications, such as neurovascular injuries. The PFNA group proved significantly superior to the DHS group regarding incision length, operation time, intraoperative fluoroscopy, blood loss and ambulation time (P<0.05) . The total complication rate was of 10.0% (5/50) in the PFNA group, while 24.0% (12/50) in the DHS group, which proved statistically significant (P<0.05) . To the latest follow up, 2 patients in the PFNA group and 3 patients in the DHS suffered from nonunion of fracture accompanied with loosening of the implants, which were treated by revision surgeries. The PFAN group was marked significantly higher Harris score than the DHS group at 3, 6 and 9 months postoperatively (P<0.05) . In term of radiographic assessment, the reduction of intertrochanteric fractures was graded as anatomic reduction in 35, functional reduction in 12 and poor reduction in 3 of the PFNA group, whereas anatomic reduction in 28, functional reduction in 17 and poor reduction in 5 of the DHS group, which was statistically significant (P<0.05) . Except the patients who suffered from nonunion, all the patients achieved bony healing of the fractures, with a mean healing time of (12.82±1.46) weeks in the PFNA group, whereas (14.23±1.61) weeks in the DHS group, which proved statistically significant (P<0.001) .[Conclusion] The PFNA is superior to DHS in clinical outcomes, and has advantage of facilitating early rehabilitation training for intertrochanteric fractures, while DHS is only suitable for the stable intertrochanteric fracture.
summary:
Proximal femoral nail anti- rotation versus dynamic hip screw for femoral intertrochanteric fracture   
WANG Yan, WANG Hai-bin, SHI Fajian, WANG Bin, ZHANG Lei, DING Zhi-yong.
Orthop J Chin, 27(24):   2223-2227.