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Abstract

BACKGROUND:

At present, there have been several intramedullary nail internal fixations being suited for the treatment of intertrochanteric fractures. PFNA-II, as the representative of new intramedullary nail internal fixations, has its unique advantages for the treatment of various types of intertrochanteric fractures.

OBJECTIVE:

To evaluate the clinical effect and operative skills of proximal femoral nail antirotation-Asia in treatment of intertrochanteric fractures.

METHODS:

A total of 39 patients with intertrochanteric fractures undergoing proximal femoral nail antirotation-Asia were retrospectively analyzed. According to AO classification, there were type A1 (n=11), type A2 (n=20) and type A3 (n=8). Duration of fixation, blood loss during fixation and proximal incision length were analyzed. Harris hip scores were used for the evaluation of clinical effect.

RESULTS AND CONCLUSION:

A total of 39 patients were followed up for 12 to 24 months, averagely 16.5 months. The average operation time was 77.1 minutes (ranged from 51 to 120 minutes) and the mean intra-operative blood loss was 85.41 mL (ranged from 39 to 185 mL). Various indexes in A1 and A2 patients were better than A3 patients (P < 0.05). However, no significant difference was detected between two groups. Harris hip score at 9 months postoperatively was ranged from 61 to 95. According to Harris hip score evaluation system,16 patients reached an excellent result, 16 good, 6 average and 1 poor, with the excellent and good rate of 82.1%. The excellent and good rate was best in type A1, followed by type A2, and was poorest in the type A3. Significant differences in excellent and good rate were detectable among three groups (P < 0.05). Results confirmed that proximal femoral nail antirotation-Asia is suitable for all types of trochanteric fractures. It is the first choice for elderly patients with osteoporosis. For complicated fracture, integrity of inner structure should be restored during operation. Mobile C-arm X-ray machine stitching technique can be used to evaluate reduction effects, which can be helpful to elevate the quality of fixation.

RESULTS AND CONCLUSION:

Funding: the Natural Science Project of Young and the Middle-Aged Scientific Research Fund of Wannan Medical College, No. WK2013F08; the Three-New Project of Yijishan Hospital of Wannan Medical College, No. Y12008

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