Comparison of Proximal Femoral Anti-rotation Intramedullary Nail and Femoral Head Replacement in Evans Ic Intertrochanteric Fracture

  • Haifeng Guo
Keywords: Femoral head replacement; Proximal femoral anti-rotation intramedullary nail; Evans Ic intertrochanteric fracture; Elderly patients


This study was designed to evaluate the efficacy of femoral head replacement or proximal femoral nailing in patients with Evans Ic type intertrochanteric fractures. Patients with Evans type Ic intertrochanteric fractures were selected for their options and to guide the accurate reconstruction of the proximal femur in elderly Chinese patients. We retrospectively studied the electronic medical records of 100 elderly patients with Evans Ic type intertrochanteric fractures older than 65 years of age. Age, gender, and proximal femoral geometric parameters (neck angle, central corner, femoral head diameter, femoral neck diameter, femoral neck length, hip axial length, and femoral shaft diameter. Statistical significance of neck angle) Difference (137.63±4.56°, 132.07±4.17°, t = 1.598, P <0.001), central corner (37.62±6.77°, 43.11±7.09°, t = 5.597, P <0.001), femoral neck diameter (35.21±) 3.25 mm vs. 34.09 ± 3.82 mm, t = 2.233, P = 0.027) and femoral neck length (99.30 ± 7.91 mm vs. 103.58 ± 8.39 mm, t = 3.715, P < 0.001) and femoral intertrochanteric fracture group. Femoral head diameter,the diameter of the femoral neck, the diameter of the femoral shaft, the axial length of the hip, and the length of the femoral neck axis were different in gender (all P < 0.001). The greater the neck angle is the risk factor for femoral neck fracture (odds ratio: 0.70, P < 0.001), the greater the central corner, the longer the femoral neck length was the risk factor for intertrochanteric fractures (odds ratio: 1.15, 1.17, P < 0.001).We demonstrate the differences in geometric parameters of the proximal femur of different protocols, as well as the effects of gender. These differences should be considered when treating femoral head replacement or proximal femoral nails in the treatment of Evans type Ic intertrochanteric fractures.