Comparative study of dynamic hip screw and proximal femoral nail antirotation in treatment of femoral intertrochanteric fracture

[Objective] To compare the effect of antirotation of proximal femoral nail(proximal femoral nail antirotation,PFNA) and artificial joint replacement(BHR) in treatment of aged patients with unstable intertrochanteric fractures.[Methods] A retrospective analysis was carried out for 96 cases with unstable intertrochanteric fracture in our hospital from January 2006 to December 2008,of which 80 cases were PFNA fixation and 80 cases were total hip replacement.The average length of stay,mean operative time,mean blood loss,blood transfusion,postoperative activity from the bed time,the incidence of postoperative complications,functional recovery of hip were compared.[Results] The artificial joint replacement surgery group had a shorter operative time,earlier off-bed activities and less blood transfusion(P﹤0.01) than those in the fixation group.Internal fixation group had more complications than that of prosthetic replacement group(P﹤0.05).50 patients of BHR group achieved excellent grade,20 patients achieved good,and the excellent rate was 87.5%;36 patients of PFNA group achieved excellent grade,20 patients achieved good,and the excellent rate was 70%;Harris hip score after one yeas of BHR Group was higher than that of the PFNA group(P﹤0.05).[Conclusion] BHR has the advantages of short processing time,less blood loss,fewer complications,and is more effective in the treatment of unstable intertrochanteric fractures.It is the ideal methods,especially suitable for elderly osteoporotic unstable intertrochanteric fractures.