To investigate the efficacy and safety of proximal femoral nail anti-rotation (PFNA) in the treatment of old intertrochanteric fractures.

A total of 82 patients with old intertrochanteric fractures confirmed by X-ray examination in our hospital between January 2017 and January 2019 were selected. They were divided into the control group and the observation group by random number method, each groups were 41 cases. The control group was treated with percutaneous compression plating (PCCP), and the observation group was treated with PFNA. The clinical efficacy, surgical status and postoperative hospital stay, preoperative, the score of Harris at postoperative 1 week, 6 months and 1 year postoperative were compared; the satisfaction rate, follow-up results and complications during the treatment period rate were counted.

The excellent and good rate in the observation group was 90.24%, and the excellent and good rate in the control group was 87.80%, there was no obvious difference in the excellent rate between the two groups (P>0.05). The surgical incision in the observation group was (11.2±3.1) cm, which was longer than [(6.5±1.7) cm, P<0.05] in the control group. The intraoperative blood loss was (157±32) ml, which was more than the [(39±12) ml, P<0.05]. The postoperative hospital stay was (12±4) d, which was shorter than that in the control group [(16±5) d, P<0.05]. There was no significant difference in surgical time between the two groups (P>0.05); the score of Harris in the observation group at 1 week after surgery was (42±6) points, which was higher than the control group's [(40±5) points, P<0.05]; the score of Harris in the observation group at the first half in the postoperative period was (82±5) points, higher than the control group [(78±5) points, P<0.05]; there was no significant difference in the score of Harris between the two groups at one year after operation (P>0.05); the satisfaction rate in the observation group was 85.37 %, the control group was 90.24% there was no significant difference in the satisfaction rate between the two groups (P>0.05). The incidence of postoperative complications in the observation group was 7.32%, and that in the control group was 19.51%. There was a statistically significant difference in the incidence of complications between the two groups (P<0.05). One year after surgery, the recurrence rate in the observation group was 4.88% and that in the control group was 12.20%. The difference between the two groups was statistically significant (P<0.05).

Using PFNA and PCCP treat the old intertrochanteric fractures has achieved good clinical results, and with PFNA treatment, the postoperative hospital stay was significantly shortened, and hip function recovery was better.