Comparison of four methods of fixation for intertrochanteric fractures in elderly patients
10.3760/cma.j.issn.1671-7368.2013.03.014
- VernacularTitle:四种内固定方法治疗老年股骨转子间骨折的对比研究
- Author:
Awei HU
;
Aixi YU
;
Chengyan XIA
;
Gang WU
- Publication Type:Journal Article
- Keywords:
Femoral fractures,intertrochanteric;
Fracture fixation,internal;
Internal fixators;
Comparative study
- From:
Chinese Journal of General Practitioners
2013;(3):185-188
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the internal fixation methods for treatment of intertrochanteric fractures in elderly patients.Methods One hundred and sixty four elderly patients with intertrochanteric fractures were treated from June 2006 to September 2011.The fractures were fixed with dynamic hip screws (DHS,n =42),locking proximal femur plate (LPFP,n =40),Gamma nails (n =36) or proximal femoral nail anti-rotation (PFNA,n =46),respectively.The clinical data were collected and the operative time,blood loss,time of clinical healing,postoperative complications and Harris hip scores of 6 months after surgery were compared among groups.Results All patients were followed-up for 6 to 36 months.The operative times of DHS,LPFP,Gamma nails and PFNA groups were (103 ± 15),(90 ± 13),(79 ± 11)and (65 ±9)min,respectively(F =2.87,P ＜0.05).The blood loss of 4 groups was (202 ±23),(181 ±23),(98 ± 13) and (87 ± 11) ml,respectively (F =3.21,P ＜ 0.05).The times of clinical fracture healing were (16.1±1.9),(14.6±1.8),(12.9±1.7) and (11.5±1.4) weeks,respectively(F=2.66,P＜0.05).The postoperative complications of 4 groups were 4/42,3/40,2/36 and 1/46,respectively (x2 =5.67,P ＜0.05).The Harris hip scores of 6 months after surgery of 4 groups were 81％ (34/42),85％ (34/40),89％ (32/36)and 93％ (43/46),respectively(H =20.03,P ＜0.05).Conclusions In treatment for intertrochanteric fractures in elderly patients,the efficacy of intramedullary fixation (Gamma nails and PFNA) is better than extramedullary fixation DHS and LPFP).PFNA is more effective than other 3 methods and should be preferentially chosen.
