The Comparison of Mortality Rates and Functional Scores of Proximal Femur Nail and Partial Hip Arthroplasty in Intertrochanteric Femur Fractures: A Retrospective Study

PFNA ve Parsiyel Kalça Artroplastisi Uygulanan İntertrokanterik Femur Kırıklarının Mortalite Oranları ve Fonksiyonel Skorlarının Karşılaştırılması

Abstract

Objective: Intertrochanteric femur fractures are common fractures with increasing life expectancy. The aim of treatment is to provide early mobilization and pre-fracture function in patients. In this study, we aimed to compare the mortality and function scores of two treatment modalities (proximal femoral nail and bipolar hemiarthroplasty) commonly used in the treatment of intertrochanteric femur fractures in a secondary care hospital. 

Materials and Methods: The study was planned for patients who underwent proximal femoral nail (PFNA) and bipolar hemiarthroplasty (BHA) due to femoral intertrochanteric fracture in a second-care hospital between 2017 and 2020. The data from a total of 199 patients were analyzed retrospectively. The operation method, age, sex, vitality, operation time, and hospitalization were recorded. The short form-36 (SF-36) questionnaire, recorded at the last visit, was evaluated in the surviving patients.

Results: No significant difference has been found for gender and age compared to the operation method. However, the mortality rate of BHA is found to be higher than the rate of PFNA (p<0.001). Compared to the time of death, no significant difference is found between operation methods. The operative time and hospitalization were significantly lower in the PFNA (p<0.01, p<0.05; respectively). At postoperative measurements, SF-36 physical functioning, energy/fatigue, emotional well-being, social functioning, pain, general health, and total scores were higher in the PFNA.

Conclusion: In this study, PFNA has low mortality and high functional scores in treating femoral intertrochanteric fractures. Therefore, PFNA is safer in a secondary hospital treating femoral intertrochanteric fractures and is recommended as a primary treatment option.