Abstract:

 [Abstract] Objective To explore the initial effects of the treatment of proximal femoral nail-helical blade (PFNA) in elderly patients with intertrochanteric fracture of the incomplete lateral wall type. Methods A total of25patients were enrolled in this study including8cases of type A2, 17cases of type A3according to AO classification. All patients under? went three-dimensional CT scan. In all patients with type A2fracture, there were 6cases with coronal plane fracture on the greater trochanter, and PFNA was used instead of DHS when an iatrogenic fracture occurred in2patients. All other patients were treated with closed reduction and fixed with PFNA.Results All patients healed and the average healing time was11 weeks, one patient fell down once again and the fracture occurred on the shaft, when a long PFNA was used, both of the frac? tures healed 14weeks after surgery. In all of the25patients,1patient died due to cerebral hemorrhage13months after sur? gery;2patients needed walking aids due to the presence of osteoarthritis of the knee and calf muscular venous thrombosis was diagnosed in3cases. No complications were found in the other patients, such as infection, nonunion and fixation failure. According to the Harris hip score system, there were14cases of“excellent”，8cases of“good”，2cases of“fair”and1pa? tient of“poor”．Conclusion The PFNA treatment can provide a good fixation for intertrochanteric fractures of incomplete lateral wall type, which allow patients to do exercise early and achieve an excellent initial outcome.

Key words: hip fracture, femor lateral wall, fracture fixation, internal, treatment outcome