Proximal femoral nail antirotation versus hemiarthroplasty: a study for the treatment of intertrochanteric fractures

Abstract

Intertrochanteric fractures in elderly patients are always associated with poor prognosis in the functional outcome as a result of the complications and mortality. A retrospective study was performed in our institution, 303 consecutive patients were followed up with mean age of 81.7 years. 147 were treated with PFNA, and 156 were underwent hemiarthroplasty. The average follow-up period was 39.9 months. The mortality at 1 month, 1 year, 3 years and the total was 6.6%, 18.6%, 27.6% and 30.3%, respectively. There were no significant differences between the groups in terms of demographic data. There were statistical significances in the operative statistics, especially the anaesthesia, operation lasting time, blood loss, blood transfusion and the drainage. There was no significant difference in Harris Hip Score between PFNA and hemiarthroplasty group, but the detail items were quite different. Significant difference was found in the excellent-to-fine rate (PFNA 90.2% and hemiarthroplasty 79.6%). Complications occurred in 34 patients, although incidences of complications were higher in hemiarthroplasty group (14.1% vs. PFNA 8.96%), no statistical difference was found. For elderly patients with intertrochanteric fractures, PFNA was superior to hemiarthroplasty according to the operative statistics, but there were no significant differences in functional outcome.