Clinical outcome of dynamic hip locking plates and proximal femoral nails anti-rotation-Asia for treating intertrochanteric femur fracture with lateral wall fractures in the elder patients

Purpose To compare the clinical results of DHLP (Dynamic hip locking plates) and PFNA-IIs (proximal femoral nails anti-rotation-Asia) for treating intertrochanteric femur fracture (IFF) with lateral wall fractures in the elder patients and provide a rationale for the clinical practice. Methods A retrospective analysis of 43 patients of IFF with lateral wall fractures was performed from December 2009 to April 2015. Intraoperative variables and postoperative complications and function were compared between the two groups. Results 17 cases were treated by DHLPs, and 26 treated by PFNA-IIs. Patients were followed up from 6 to 16 months with an average of 11 months. Both the groups were comparable for demographic data before surgery. The PFNA-II group had less operation time, time of full weight bearing and healing time of fracture, but larger blood loss in comparison with the DHLP group (p<0.05). Additionally, internal fixation failure was significantly more in the DHLP group than in the PFNA-II group. The mean HHS and the rate of good-to-excellent in the PFNA-II group was significantly higher than that in the DHLP group both in third month after surgery (p<0.05). Conclusions PFNA-IIs treatment should be recommended for the elderly patients of IFF with lateral wall fractures, because of its shorter operation time, faster full weight bearing, faster function recovery, and lower failure rate. However, more attention should be payed to its larger blood loss.