Treatment of Coronal Plane Femoral Intertrochanteric Fractures with a Microexternal Fixator Combined with Proximal Femoral Nail Antirotation

OBJECTIVE: To investigate the different efficacy of proximal femoral nail antirotation (PFNA) combined with or without a microexternal fixator in the treatment of coral-plane femoral intertrochanteric fractures. METHODS: 120 patients with intertrochanteric coronal fractures who received treatment in four hospitals from February 2020 to February 2021 were retrospectively included in this study. They were divided into control (PFNA alone, n = 60) and combined treatment group (a microexternal fixator + PFNA, n = 60) according to different surgery methods. All patients were followed up for 6 months. Operative time, amount of intraoperative blood loss, postoperative length of hospital stays, fracture healing time, Harris hip score, modified Barthel index, hip function excellent and good rate, and incidence of complications were compared between the two groups. RESULTS: There were no significant differences in operative time, amount of intraoperative blood loss, postoperative length of hospital stay, and incidence of complications between the two groups (all P > 0.05). Fracture healing time in the combined treatment group was significantly shorter than that in the control group (P < 0.05). After surgery, Harris hip score and modified Barthel index in each group were significantly increased compared with before surgery (both P < 0.05). The increases in Harris hip score and modified Barthel index in the combined treatment group were significantly greater than those in the control group (both P < 0.05). After surgery, Harris hip function excellent and good rate in the combined treatment group was significantly higher than that in the control group (83.33% > 66.67%, P < 0.05). CONCLUSION: Compared with PFNA alone, a microexternal fixator combined with PFNA for the treatment of coronal plane femoral intertrochanteric fractures can greatly shorten fracture healing time and improve postoperative hip function and activities of living ability, but it cannot greatly increase operative time, the amount of intraoperative blood loss, or the risk of postoperative complications.