OBJECTIVETo investigate the selective strategy of the internal fixation methods in treating intertrochanteric femoral fracture by comparing the different methods.

METHODSData of 326 cases of intertrochanteric femoral fractures treated with different internal fixation methods were concluded. One hundred and sixty-five cases were treated with the dynamic hip screws (DHS group), 78 male, 87 female, age 38 to 98 years. One hundred and three cases were treated with the anatomical plates of proximal femur (AP group), 48 male, 55 female, age 39 to 89 years. Fifty-eight cases were treated with the fixation expandable proximal femoral nails (PFN group), 31 male, 27 female, age 41 to 92 years. According to Evans classification of intertrochanteric femoral fractures, fractures were divided into type I, II, III, IV and retro-intertrochanteric type. The cases of each type of three groups were DHS(12, 35, 61, 42, 15); AP(9, 23, 38, 25, 8); PFN (6, 13, 21, 13,5). Data of each group was collected for statistical analysis on the following aspects: operation time,blood loss, fluoroscopy exposures, drainage, clinical healing time of fracture, post-operative restored function and the total complications.

RESULTSThe difference of operation time, blood loss, fluoroscopy exposures, drainage, clinical healing time of fracture, post-operative restored function were of statistical significance (P < 0.01). In comparing with group DHS and AP, group PFN was of less operation time, blood loss, drainage, clinical healing time of fracture, but more fluoroscopy exposures, and the post-operative restored function of group PFN was more satisfied. The difference of operative complications were of no statistical significance (P = 0.05).

CONCLUSIONThe fixation expandable proximal femoral nail is a good choice for intertrochanteric femoral fracture.