Clinical results of intramedullary and hemiarthroplasty in treatment of intertrochanteric fracture with coronal fracture in elderly

Abstract

Objective: To campare the effectiveness of intramedullary and hemiarthroplasty in treatment of intertrochanteric fracture with coronal fracture in elderly Methods: A retrospective analysis of 50 elderly patients with intertrochanteric fracture with coronal fracture who performed operation between July 2017 and February 2022. According to the different surgical methods ,the patients divided into 2 groups: Group A(27 cases , performed with PFNA/Intertan) and Group B(23 cases, performed with hemiarthroplasy). There was no significant difference in age,gender,BMI,preoperative VAS score,preoperative hemoglobin and serum albumin levels，preopertive prepare time(P＞0.05).Operation time, intraoperative blood loss ,length of hospital stay,postoperative VAS score,postoperative hemoglobin and serum albumin levels,complication，Harris score of postoperative 1,3,6 months were record and compared between the two groups. Results: There was no significant difference in operation time, length of hospital stay, postoperative hemoglobin and serum albumin level，complications between the two groups. There was significant difference in intraoperative blood loss between the two groups (P=0.001). The postoperative VAS scores of the two groups were no significant difference, but the postoperative VAS score were significant greater than preoperative in intra-group . Both of the two operations could effectively relieve pain. The Harris scores of the two groups were statistically significant at 1 month and 3 months after operation, and the function of hemiarthroplasty was better than that of intramedullary fixation, but there was no statistical significance between the two groups at 6 months. However, both surgical can significantly improve the function of patients. Conclusion: Both PFNA/Intertan intramedullary fixation and hemiarthroplasty can achieve good results for intertrochanteric fractures combined with coronal fractures. The existence of coronal fracture can increase the difficulty of operation. The early functional recovery of hemiarthroplasty is better than that of intramedullary fixation, but with the passage of time, intramedullary fixation can also achieve better function.