Computed Tomographic Image Analysis of Proximal Femoral Nail Antirotation and Dynamic Hip Screw in the Treatment of Intertrochanteric Fractures

摘要

Objective: Based on the observation of Computed Tomography (CT) image analysis technique, the efficacy of Proximal Femoral Nail Antirotation (PFNA) and Dynamic hip screw (DHS) in the treatment of intertrochanteric fractures in the elderly was analyzed. Methods: Thirty-nine elderly patients with unstable intertrochanteric fractures were randomly divided into two groups: 19 patients in the DHS internal fixation group and 20 patients in the PFNA group. They were treated with DHS and PFNA internal fixation, and were observed based on CT image analysis techniques. The patient performs follow-up testing of the procedure before and after surgery. Results: There was a statistically significant difference in mean operative time and intraoperative blood loss between the groups (P < 0.01). The incidence of intraoperative and postoperative complications was statistically different between the two groups (P < 0.05). The incidence of postoperative and postoperative complications in the PFNA group was lower than that in the DHS group. The excellent and good rates of DHS group and PFNA group were 89.47% and 95.00%, respectively. There was no significant difference between the two groups (P > 0.05). There was a significant difference in fracture healing time between the PFNA group and the DHS group (P < 0.01). Discussion: Compared with DHS, PFNA has the advantages of short operation time, low bleeding volume and short hospital stay. There were 7 cases of internal fixation failure or non-union in the DHS group and 1 case of delayed healing in the PFNA group. Conclusion: DHS and PFNA were used to treat intertrochanteric fractures in the elderly. After observation by CT image analysis technique, there was no significant difference in efficacy. The average operative time of PFNA was the shortest, the intraoperative blood loss was the least, the incidence of intraoperative and postoperative complications was low, and the fracture healing time was short. PFNA has a lesser effect on the blood circulation and bone destruction at the fracture end, and it is more secure. It is a reasonable surgical method for the treatment of senile osteoporotic intertrochanteric fractures.