[Comparison of proximal femoral nail and dynamic hip screw for treating intertrochanteric fractures].

OBJECTIVE: To discuss characters of proximal femoral nail and dynamic hip screw for treating type A1, A2, A3 of intertrochanteric fractures.

METHODS: We review 104 patients with intertrochanteic fractures, 33 patients were treated with proximal femoral nail (PFN), including 13 males and 20 females with an average age of 76 years (ranging from 63 to 87 years). 12 cases of type A1; 18 cases of type A2 and 3 cases of type A3; and 71 patients were treated with dynamic hip screw (DHS), including 29 males and 42 females with an average age of 74.5 years (ranging from 61 to 92 years), 32 cases of type A1, 34 cases of type A2 and 5 cases of type A3. Comparision in an average time of operations, the length of incision, blood loss, weight loading time and complications between two groups.

RESULTS: An average time of operation was (51.5 +/- 4.4) min in PFN; (68.8 +/- 5.9) min in DHS. The length of incision was (9.6 +/- 0.9) cm in PFN; (15.5 +/- 1.5) cm in DHS. The blood loss was (179.0 +/- 12.9) ml in PFN; (269.3 +/- 40.0) ml in DHS. Varus collapse was none in PFN, 1 case in DHS. The collodiaphyseal angle of 7 cases decreased in DHS. Lateral hip pain caused by proximal screw removal was 6 cases in PEN.

CONCLUSION: The therapeutic effect of DHS and PEN was primitively same in treating type A1 of intertrochanteric fracture. Operative injuries of PFN were less than that of DHS and anti-tonia was more stronger which is more suitable for type A2 and A3 of intertrochateric fractures.