Minimally invasive treatment of femoral intertrochanteric fracture in osteoporotic elderly patients:A retrospective study
10.11855/j.issn.0577-7402.2017.08.10
- VernacularTitle:微创治疗老年不稳定股骨转子间骨折伴骨质疏松症的回顾性研究
- Author:
Long XIN
;
Weixing XU
;
Leijun YU
;
Jian WANG
;
Hongpu SONG
;
Fuhua ZHONG
;
Yiyang LIU
;
Hong LIU
;
Chun ZHANG
- Keywords:
osteoporotic fractures;
femoral fractures;
fracture fixation;
intramedullary;
surgical procedures;
minimally invasive
- From:
Medical Journal of Chinese People's Liberation Army
2017;42(8):712-716
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical outcomes of minimally invasive internal fixation for femoral intertrochanteric fracture in osteoporotic elderly patients. Methods A retrospective study was conducted in 112 patients using interan nail (IN) or trochanteric antegrade nail (TAN) for the management of intertrochanteric femoral fracture from January 2009 to September 2015 in our hospital. According to AO classification, there were 34 cases of type 31-A.1, and 61 cases of type 31-A.2, 17 cases of type 31-A.3. Clinical and radiological follow-up were available. Surgical and fluoroscopic time, length of hospital stay, blood loss, complications and hip functions were compared between two groups. Results A total of 78 patients meeting the criteria were evaluated at a mean follow-up of 15 months (range, 3-27 months). The IN was used in 41 patients and the TAN in 37 patients. Operative time, fluoroscopy time and blood loss showed significant difference between the IN group and TAN group (respectively, 58.9±6.9 vs. 75.6±5.9min; 2.70±0.47 vs. 4.40±0.47min; 107.6±6.7 vs. 127.8±6.8ml, P<0.05), suggesting that patients treated with the IN experienced shorter operative and fluoroscopy times, less blood loss and better hip function (73%) than those with TAN (65%, P<0.05). Rate of postoperative complications was lower in the IN group (4.9%) than in the TAN group (10.8%, P<0.05). There was no difference in hospital stay and fracture healing time between the two groups (P>0.05). Conclusions For minimally invasive treatment of unstable femoral intertrochanteric fractures, use of either the IN or TAN is clinically effective. However, IN presents more advantages (e.g., easy operation, reliable fixation, less bleeding, better clinical outcomes, and less complications). The use of IN is a suitable option for the treatment of unstable intertrochanteric fractures in osteoporotic elderly patients.
