Key result
Artificial femoral head replacement yielded better hip joint function and pain scores than PFNA, though PFNA had shorter operation time and less blood loss (P 0.05).
Why the study?
The study was conducted to compare the clinical efficacy of artificial femoral head replacement and proximal femoral nail antirotation for unstable femoral intertrochanteric fractures in elderly patients.
Does artificial femoral head replacement improve clinical efficacy and hip function compared to PFNA in elderly patients with unstable intertrochanteric fractures?
Cohort (n=60)
Does artificial femoral head replacement improve clinical efficacy and hip function compared to PFNA in elderly patients with unstable intertrochanteric fractures?
Artificial femoral head replacement provides better early hip joint function and pain relief compared to PFNA for elderly patients with unstable intertrochanteric fractures, despite longer operation times and more blood loss.
May support PFNA over replacement for function in elderly unstable fractures; leaves open need for RCTs before changing practice.
Objective: To compare the clinical efficacy of artificial femoral head replacement and Proximal femoral nail antirotation (PFNA) in the treatment of unstable femoral intertrochanteric fractures in the elderly. Methods: This study retrospectively analyzed 60 elderly patients with unstable intertrochanteric fractures treated with PFNA and artificial femoral head replacement from 2015.06 to 2018.06, of which 34 were in the PFNA group (Group A) and 26 in the artificial femoral head replacement group (Group B). Statistical analysis of relevant surgical indicators such as surgical time, intraoperative blood loss, postoperative blood transfusion, postoperative time to landing, postoperative infection rate, hospital stay, number of secondary operations, postoperative VAS score, and postoperative Hip function score comparison. Results: All 60 patients were followed up for 1 - 24 months. Compared with the artificial femoral head replacement group, the operation time of PFNA group was shorter, the blood loss during operation was less, and the difference was statistically significant (P 0.05). Conclusion: The hip joint function and pain scores of the artificial femoral head replacement group in the early and follow-up periods are better than those of the PFNA group. The artificial femoral head replacement is more suitable for the treatment of elderly unstable intertrochanteric fractures.
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Qian et al. (2020) conducted a cohort in unstable intertrochanteric fractures (n=60). Artificial femoral head replacement vs. Proximal femoral nail antirotation (PFNA) was evaluated on operation time and blood loss (p=0.05). Artificial femoral head replacement yielded better hip joint function and pain scores than PFNA, though PFNA had shorter operation time and less blood loss (P 0.05).
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