Treatment of the Unstable Intertrochanteric Fracture with Proximal Femoral Nail Antirotation: Comparison with Compression Hip Screw with Trochanteric Stabilizing Plate

Abstract

Purpose:To evaluate the effectiveness of Proximal Femoral Nail Anti-rotation (PFNA) for the treatment of unstable intertrochanteric fracture comparing with Compression Hip Screw (CHS) with Trochanteric Stabilizing Plate (TSP). Materials and Methods: With clinical study, 43 patients who were treated surgically for unstable intertrochanteric fractures were retrospectively evaluated. One group was treated with CHS and TSP (Group 1, 22 cases) and the other was treated with PFNA (Group 2, 21 cases). By postoperative radiograph and last follow up radiograph we measured Tip-apex distance, Cleveland index, Lag screw slippage, Neck-shaft angle change and Union time. And By retrospective medical record review, the clinical results were evaluated with the operation time, intraoperative estimated blood loss, amount of drainage, amount of transfusion, walking ability change and complication. Results: There was a lower operation time, intraoperative estimated blood loss, amount of drainage, amount of transfusion, lag screw slippage and neck shaft angle change in the Group 2 than in the Group 1 (p＜0.05).

A Comparison between Compression Hip Screw and Intramedullary Nail for the Treatment of AO/OTA A2.2 Intertrochanteric Femoral Fracture

“…A2형에서는 압박 고나사와 골수강 내 금속정이 차이가 없다는 보고도 있으며 3) , 세분화해서 보면 A2.1형은 안정성 골절로 압박 고나사가 최선의 치료로 알려져 있고, 불안정 성 골절인 A2.2형부터는 골수강 내 금속정이 압박 고나사 보다 수술 시간 및 출혈량 등이 작아 덜 침습적인 방법으 로 노인 환자에게 유용할 것이라는 보고들이 있다 13) . 이에 저자들은 안정성 골절과 불안정성 골절의 경계부에 있는 AO/OTA 31-A2.2형에 대한 치료에 대해서 압박 고 나사와 골수강 내 금속정의 치료 결과를 후향적으로 분석 하여 어떤 치료법이 좋은가를 알아보고자 하였다.…”