Comparison of clinical outcomes with proximal femoral nail anti-rotation versus bipolar hemiarthroplasty for the treatment of elderly unstable comminuted intertrochanteric fractures

Although proximal femoral nail anti-rotation (PFNA) and bipolar hemiarthroplasty (BHA) are selected by most of the orthopaedic surgeons for elderly intertrochanteric fractures (ITFs) patients, there is still no consensus on the superiority of PFNA and BPH for the elderly with unstable comminuted ITF...

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Published in:BMC musculoskeletal disorders 2022-07, Vol.23 (1), p.628-7, Article 628
Main Authors: Song, Qi-Chun, Dang, Sha-Jie, Zhao, Yan, Wei, Ling, Duan, Da-Peng, Wei, Wen-Bo
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Bipolar hemiarthroplasty
Bone density
Bone Nails
Bone surgery
Care and treatment
Classification
Clinical outcomes
Comparative analysis
Complications
Disease
Elderly
Femur
Fracture fixation
Fractures
Fractures, Comminuted - diagnostic imaging
Fractures, Comminuted - surgery
Gait
Hemiarthroplasty - adverse effects
Hip
Hip Fractures - surgery
Hip joint
Hospitals
Humans
Injuries
Intertrochanteric fracture
Medical personnel
Medical records
Methods
Mortality
Musculoskeletal diseases
Older people
Patient outcomes
Patients
Postoperative
Postoperative Complications - surgery
Prostheses
Proximal femoral nail antirotation
Questionnaires
Retrospective Studies
Statistical analysis
Unstable
Walking
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Summary:Although proximal femoral nail anti-rotation (PFNA) and bipolar hemiarthroplasty (BHA) are selected by most of the orthopaedic surgeons for elderly intertrochanteric fractures (ITFs) patients, there is still no consensus on the superiority of PFNA and BPH for the elderly with unstable comminuted ITFs. The study aims to compare the curative effects of PFNA and cementless BHA on unstable comminuted ITFs in the elderly. From January 2012 to December 2016, we retrospectively reviewed 62 ITFs patients up to the inclusion and exclusion criteria in the study. Depending on the type of surgery, the patients were divided into two groups: Group BHA (n= 30) and Group PFNA (n = 32). The ITFs were classified according to Evans-Jensen. Hospitalization time, operation time, bleeding loss, weight bearing duration, Harris hip scores, 10-m walking speed, gait and postoperative complications were compared between the two groups. There was no significant difference between the groups in hospital stay (P > 0.05). The BHA group trended to have a shorter operation time and a larger volume of blood loss (P 
ISSN:1471-2474
1471-2474
DOI:10.1186/s12891-022-05583-4