| Objective To explore the clinical efficacy of proximal femoral nail antirotation (PFNA) between supine position with traction bed and lateral position with non-traction in the treatment of elderly coal miner patients with Evans-Jensen type Ⅱ、Ⅲ femoral intertrochanteric fracture. Methods All 70 cases of elderly coal miner patients with Evans-Jensen type Ⅱ、Ⅲ femoral intertrochanteric fracture after PFNA surgery from September 2013 to December 2016 were divided into two groups: the lateral position group and the supine position group. The clinical efficacy of the two groups was analyzed by comparing the operation time, blood loss, incision length, healing time, complications and Harris scores. Results All 70 patients were followed up for 10 to 27 months, with an average of 18.6 months. Lateral position group: operation time (75.19±5.75) min, intraoperative blood loss (150.33±8.07) mL and incision length (77.22±5.70) mm. Supine position group: operation time (89.76±6.52) min, intraoperative blood loss (159.97±7.70) mL and incision length (100.35±6.26) mm. The difference between groups was statistically significant (P<0.05). Lateral position group: postoperative complication rate 8.3%, fracture healing time (12.94±0.92) weeks, and Harris hip function score (89.69±6.10) at 6 months after operation. Supine position group, postoperative complication rate 8.8%, fracture healing time (13.06±1.58) weeks, and Harris hip function score (88.76±6.33) at 6 months after operation. There was no significant difference between the two groups (P>0.05). Conclusion In two different postures, PFNA surgery can achieve good results in the treatment of elderly coal miner patients with Evans-Jensen type Ⅱ、Ⅲ femoral intertrochanteric fracture. However, the lateral position group with non-traction bed makes the operation more minimally invasive, easier, shorter and less bleeding. |
