Choice of Operations for Femoral Intertrochanteric Fractures in Elderly Patients

Objective To explore a reasonable operation treatment for femoral intertrochanteric fracture in the elderly patients.Methods One hundred and fifty-eight aged patients with intertrochanteric fractures were included in the study.Of all the patients,59,46 and 53 cases were treated by DHS,Gamma nail and PFNA respectively.All the cases were followed up.The operative procedures,complication incidences,therapeutic effects and bone fracture healing time of the three groups were compared.Results There were statistical difference in the mean operation time and the blood loss among the DHS fixation group,Gamma nail fixation group and PFNA fixation group(P0.01).There was statistical diference in intraoperative and postoperative complications incidence rate between the three groups(P0.05),PFNA group incidence of intraoperative and postoperative complications were lower than DHS group.The excellent rate of DHS group,Gamma nail group and PFNA group was 86.44 %,84.78% and 90.57% respectively(P0.05).There were statistical difference in the bone fracture healing time in PFNA fixation group and DHS group(P0.01),but the differences between Gamma nail fixation group and PFNA fixation group were of no statistical significance(P0.05).Conclusions There was no significant difference among three operative methods as far as the therapeutic effect was concerned.The mean operation time was the shortest,the intraoperative blood loss was the least,intraoperative and postoperative complications incidence rate was low and the bone fracture healing time was short in the PFNA fixation group.PFNA compromises less vascular support and osseous,and provides more stable fixation,which is a reasonable way for aged intertorchanteric fractures.