Clinical outcome of dynamic hip locking plates and proximal femoral nails anti-rotation-Asia for treating intertrochanteric femur fracture with lateral wall fractures in the elder patients
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Hui Xie1,*, Zhan Wang2,*, Junji Zhang3, Langhai Xu2 and Bao Chen1
1Department of Orthopaedics, Jiaxing No. 2 Hospital, Jiaxing University, Jiaxing 314001, China
2Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopaedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China
3Department of Infection Management, Suzhou Municipal Hospital, Suzhou 215002, China
*These authors have contributed equally to this work
Bao Chen, email: [email protected]
Keywords: IFFs (intertrochanteric femur fractures), lateral wall fracture, DHLP (dynamic hip locking plates), PFNA-IIs (proximal femoral nails anti-rotation-Asia)
Received: May 25, 2017 Accepted: June 19, 2017 Published: July 31, 2017
Purpose: To compare the clinical results of DHLP (Dynamic hip locking plates) and PFNA-IIs (proximal femoral nails anti-rotation-Asia) for treating intertrochanteric femur fracture (IFF) with lateral wall fractures in the elder patients and provide a rationale for the clinical practice.
Methods: A retrospective analysis of 43 patients of IFF with lateral wall fractures was performed from December 2009 to April 2015. Intraoperative variables and postoperative complications and function were compared between the two groups.
Results: 17 cases were treated by DHLPs, and 26 treated by PFNA-IIs. Patients were followed up from 6 to 16 months with an average of 11 months. Both the groups were comparable for demographic data before surgery. The PFNA-II group had less operation time, time of full weight bearing and healing time of fracture, but larger blood loss in comparison with the DHLP group (p<0.05). Additionally, internal fixation failure was significantly more in the DHLP group than in the PFNA-II group. The mean HHS and the rate of good-to-excellent in the PFNA-II group was significantly higher than that in the DHLP group both in third month after surgery (p<0.05).
Conclusions: PFNA-IIs treatment should be recommended for the elderly patients of IFF with lateral wall fractures, because of its shorter operation time, faster full weight bearing, faster function recovery, and lower failure rate. However, more attention should be payed to its larger blood loss.
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