Classifying intertrochanteric fractures of the proximal femur: does experience matter?

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Abstract

[Indexed for MEDLINE] 6. Zhongguo Gu Shang. 2019 Sep 25;32(9):824-829. doi: 10.3969/j.issn.1003-0034.2019.09.010. [Comparison of PFNA and DHS for the treatment of elderly unstable intertrochanteric fractures of femur]. [Article in Chinese] Lu JF(1). Author information: (1)Zhuji Sixth People's Hospital, Zhuji 311800, Zhejiang, China; 449152571@qq.com. OBJECTIVE: To compare the clinical efficacy of proximal femoral nail anti-rotation(PFNA) and dynamic hip screw(DHS) for the treatment of unstable intertrochanteric fractures in the elderly. METHODS: From January 2012 to December 2015, 83 elderly patients with unstable intertrochanteric fracture of femur were divided into 45 cases treated with PFNA and 38 cases treated with DHS. In the PFNA group, there were 24 males and 21 females, aged 82 to 94(88.35±6.12) years old, duration was 1.5 to 10 (4.33±1.07) h, causes of injury involved 33 traffic accidents, 10 falls at high altitude, 2 falls; Evans-Jensen classification involved 21 cases of IIIA, 18 cases of IIIB and 6 cases of IV. In DHS group, there were 20 males and 18 females, aged 83 to 95 (88.77±5.52) years old, duration was 1 to 10 (4.37±1.05) h, 27 traffic accidents, 10 high-altitude falls and 1 fall injury, and Evans-Jensen classification involved 18 cases of IIIA, 15 cases of IIIB and 5 cases of IV. The operation time, intraoperative bleeding volume and discharged complications were observed and compared between the two groups. The Mos 36-item Short Form Health Survey (SF-36) was used to measure the quality of life before and 12 months after operation. Harris score was used to evaluate hip function 12 months after operation. RESULTS: The operation time, intraoperative bleeding volume and complication rate in PFNA group were significantly lower than those in DHS group(P