Abstract Objective：To investigate characteristics，surgical methods and initial efficacy of the anti-rotation type proximal nail（proximal femoral nail antirotation，PFNA）in treatment of elderly patients with unstable femoral intertrochanteric fracture.Method：26 elderly patients with unstable femoral intertrochanteric fracture who treated with PFNA from March 2008 to December 2012 were selected，11 cases were male，15 cases were female，65-97 years old， the mean age was 78.2 years.According to AO classification，A2 type was 16 case，A3 was 10 case.After admission，17 patients were treated with skin traction，9 patients were treated with skeletal traction.Patients underwent surgery after admission 2-4 d，underwent traction manipulation by lower limb traction bed of orthopaedics in the surgery，PFNA was placed into small incision，in surgery couldn’t be exposed fracture.Result：In 26 patients，the average operation time was 55 min（40-110 min），the average amount of bleeding was 80 mL（30-200 mL），1 patient transferred to medical
treatment because of lung infection and 2 cases combined deep venous thrombosis（DVT），the remaining patients were discharged from the hospital.Followed up for 5-48 months，an average of 20 months，partial weight-bearing was 2 weeks，the full weight-bearing walking time was 4 weeks，fracture healing time was 10 weeks，patients were no incision nfection，deep vein thrombosis，internal fixation loosening and hip varus complications.According to the Harris hip function score：excellent in 18 cases，good in 4 cases，general in 2 cases，poor in 1 case.the excellent and good rate was 84.6%.Conclusion：PFNA combined with traction bed treatment of unstable intertrochanteric femoral fractures has less trauma，simple operation，less complications，internal fixation and other advantages，is worthy of clinical application.
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