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Zeng X, Zhang N, Zeng D, Zhang L, Xu P, Cao L, Yu W, Zhan K, Zhang X. Proximal femoral nail antirotation versus dynamic hip screw fixation for treatment of osteoporotic type 31-A1 intertrochanteric femoral fractures in elderly patients. J Int Med Res 2017; 45:1109-1123. [PMID: 28417681 PMCID: PMC5536426 DOI: 10.1177/0300060517703277] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To evaluate long-term radiographic and functional outcomes between dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA) fixation for treatment of osteoporotic type 31-A1 intertrochanteric femoral fractures (IFFs) among elderly patients Methods A retrospective comparative study was carried out. Follow-up was performed at 1, 3, 6, 9, and 12 months postoperatively and yearly thereafter. The primary outcome was the radiographic outcome, and the secondary outcome was the functional outcome. Results A significant difference in radiographic complications was observed between the DHS group (n = 45, 40.2%) and PFNA group (n = 15, 13.6%). The risk of femoral shaft fracture after implant removal at the 1-year follow-up was increased by 0.9% (n = 1) and 6.3% (n = 7) in the PFNA and DHS groups, respectively. This difference persisted with rates of 3.6% (n = 4) and 12.5% (n = 14) at the final follow-up. Additionally, significant differences were present in the Harris hip score at each visit. Conclusion Our results indicate that PFNA yields better outcomes than DHS fixation among elderly patients with osteoporotic type 31-A1 IFFs.
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Affiliation(s)
- Xianshang Zeng
- 1 Department of Orthopedics, The First Affiliated Hospital of Sun Yat-sen University, Huangpu District, Guangzhou, Guangdong, China
| | - Nan Zhang
- 2 Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, Huangpu District, Guangzhou, Guangdong, China
| | - Dan Zeng
- 3 Ultrasonography Department, The First Affiliated Hospital of Sun Yat-sen University, Huangpu District, Guangzhou, Guangdong, China
| | - Lili Zhang
- 2 Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, Huangpu District, Guangzhou, Guangdong, China
| | - Ping Xu
- 4 Radiology Department, The First Affiliated Hospital of Sun Yat-sen University, Huangpu District, Guangzhou, Guangdong, China
| | - Lei Cao
- 5 Department of Anesthesiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Jiang'an District, Wuhan, Hubei, China
| | - Weiguang Yu
- 1 Department of Orthopedics, The First Affiliated Hospital of Sun Yat-sen University, Huangpu District, Guangzhou, Guangdong, China
| | - Ke Zhan
- 1 Department of Orthopedics, The First Affiliated Hospital of Sun Yat-sen University, Huangpu District, Guangzhou, Guangdong, China
| | - Xinchao Zhang
- 6 Department of Orthopaedics, Jinshan Hospital, Fudan University, Jinshan District, Shanghai City, China
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