Comparative study on proximal femur locking plate and proximal femoral nail anti-rotation II in treating intertrochanteric fracture in the elderly

Objective: To compare and analyse retrospectively the clinical effect of Proximal Femoral Nail AntiRotation II (PFNA-II) and Proximal Femur Locking Plate (PFLP) for the treatment of intertrochanteric fracture in the elderly. Methods: A total of 161 elderly patients with intertrochanteric fracture, who underwent either PFNA or PFLP in our hospital from March 2012 to March 2013, were enrolled in the study. These patients were assigned into PFNP group and PFLP group. The perioperative bleeding, duration of the surgery, mean out-of-bed time after surgery, mean length of stay, complications, mean perioperative loss of hemoglobin, mean healing time of fracture and Harris scores of both groups were evaluated. The postoperative adverse reactions were compared. Results: In comparison with PFLP group, the perioperative bleeding, duration of the surgery, mean length of stay, mean off-bed time after surgery, mean perioperative loss of hemoglobin and mean healing time of fracture were significantly lower in PFNA group, P<0.05. However, the duration of fluoroscopy time and hip function between 2 groups were not significantly different, P>0.05. And there were no significant differences in patient satisfaction, cutting of head and neck, incidence of incision infection, failure rate of internal fixation, and mortality in follow-up period between 2 groups, P>0.05. In comparison with PFNA group, the greater trochanter pain of patients was significantly milder and the rate of loose screws was significantly lower in PFLP group, P<0.05. Conclusion: For the treatment of intertrochanteric fracture in the elderly, surgery methods should be selected appropriately based on the fracture type and degree of osteoporosis.