*Corresponding author:Andika Dwicahyo, Staff of Orthopaedic and Traumatology department, Gadjah Mada University, Yogyakarta, Indonesia
Received: December 13, 2018; Published: December 20, 2018
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Background: Hip fractures had become an increasing health problem throughout the world in parallel with the global aging population. Many treatment methods have been used for the reduction of intertrochanteric fractures, including extramedullary and intramedullary fixation. The aim of this study was to compare the outcomes of intertrochanteric femur fractures treated with proximal femoral plate (PFP) and cephalomedullary nail (PFNA) in Sardjito general hospital.
Materials and Methods: A total of fifty one patients with intertrochanteric femur fractures treated surgically with either PFP or PFNA in our hospital between January 2013 and December 2017 were included into the study. Patients demographics, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) classification, and the American Society of Anesthesiologists (ASA) classification system scores, type of surgical procedure (PFP or PFNA), operative details, complications and follow-up scores (Harris Hip Score [HHS]) were recorded.
Results: There’re 25 patients in PFP group and 26 patients in PFNA groups with the preoperative characteristics of the patients in both groups were similar. PFP group has higher intraoperative blood loss and number of patients transfused postoperatively compared to PFNA group (249.2±74.27 ml and 41.18% vs 163.9±113.81 ml and 23.53%) with p<0.05. There were no significant differences in number of complications occurred (3.92% vs 1.96%) and length of hospital stay (12.08±5.03 days vs 11.58±4.31 days) in both PFP and PFNA group with p>0.05. At the last follow-up with 42.63±17.7 months in PFP group and 25.05±11.4 months in PFNA group, there were no significant differences in HHS (80.16±10.13 vs 84.33±7.09) and number of mortality (7.5% vs 2.5%) with p>0.05. There is significant correlation between age and HHS score with negative koefisien (-0,372) and p<0.05.
Conclusion: Both PFP and PFNA fixation in intertrochanteric femur fracture patients resulting good functional outcome with HHS more than 80 at more than 6 months follow-up, however PFNA had advantages in lower intraoperative blood loss and the number of patients need to be transfused postoperatively. Also, the age of patients at the time of surgery correlate negatively with the HHS postoperative.
Keywords :Intertrochanteric Femur Fracture; Proximal Femoral Nail Anti Rotation; Proximal Femoral Plate; Functional Outcome; Harris Hip Score; Cephalomedullary Nail
Abbreviations : PFP: Proximal Femoral Plate; AO/ASIF: Association for Osteosynthesis/Association for the Study of Internal Fixation; HHS: Harris Hip ScoreIntroduction| Methods| Results and Discussion| Conclusion| References|