Proximal femoral nail antirotation (PFNA) and Hemiarthroplasty in the treatment of elderly intertrochanteric fractures

Abstract

Objective: To investigate reasonable treatment of intertrochanteric fractures with proximal femoral nail antirotation (PFNA) or Hemiarthroplasty (HA) in elderly patients.Methods: In January 2009 to June 2013 367 patients were admitted in our hospital. Comparison between the two methods (PFNA and Hemiarthroplasty) was done with the time duration of the surgery, intra-operative blood loss, and postoperative weight bearing time, implant complications and The Harris hip score.Results:  Results were analyzed after 50 months of follow up. In comparison of the surgical time duration between the PFNA group the Hemiarthroplasty group, Hemiarthroplasty had shorter duration of surgical time.  The intra operative blood loss of PFNA was significantly less than Hemiarthroplasty. Post operative weight bearing time was significantly shorter in Hemiarthroplasty than PFNA.  Conclusion:  For elderly patients with unstable fractures, severe osteoporosis and preoperative mobility can be preferred to Hemiarthroplasty.  The proximal femoral nail Antirotation (PFNA) for the treatment of intertrochanteric fractures has been increasingly accepted and widely used