Selection of the internal fixation for various types of intertrochanteric fracture in aged patients and prevention for complication.
- Author:
Xin GE
1
;
Jian-Ming ZHANG
;
Wei-Cheng LU
;
Shui-Qiang QIU
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Aged, 80 and over; Bone Screws; Female; Fracture Fixation, Internal; methods; Fracture Fixation, Intramedullary; methods; Fracture Healing; physiology; Hip Fractures; complications; surgery; Humans; Joint Instability; physiopathology; Male; Middle Aged; Postoperative Complications; prevention & control
- From: China Journal of Orthopaedics and Traumatology 2009;22(5):385-386
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the results and indication of differently internal fixation for intertrochanteric fracture and prevent for complication.
METHODSOne hundred and two patients of intertrochanteric fracture of femur from January 1997 to December 2007 were reviewed and analysed. There were 46 males and 56 females, with an average age of 76.5 years ranging from 60 to 93 years. There were 34 cases of stability fractures and 68 of instability fractures. The methods of internal fixation included dynamic hip screw in 82 cases, proximal interlocking nail in 5, multi-screw fixation in 9, dynamic codylar screw in 6.
RESULTSThese patients were followed up for 6 to 72 months (36 months in average). The time of fracture healing was from 8 to 12 weeks. According to evaluation criterion of effect, the results were excellent in 72 cases, good in 20, fair in 10. After operation, there were 3 cases of coax vara, 2 cases of lag screws cutting out, 1 case of breakage of screw, 2 cases of avascular necrosis of the femoral head, 1 case of postoperative infection, 1 case of delayed union.
CONCLUSIONSuitable implant selection according the type of fracture, health condition is an important factor to reduce the incidence of complication for unstable fracture in aged patients. DHS is a main treatment of intertrochanteric fracture. PFN is recommended for serious osteoporosis or unstable intertrochanteric fracture. Compression screws is a choice for the fixation of type I and type II fracture of bad health condition.