1.Fixation with three kinds of implants to repair osteoporotic intertrochanteric fractures: univariate and multivariate analysis of failure
Bo ZHOU ; Qi ZHU ; Shutao ZHONG
Chinese Journal of Tissue Engineering Research 2015;19(17):2719-2723
BACKGROUND:Intertrochanteric fracture is one of the common complications in patients with senile osteoporosis.Internal fixation is a common method in clinical therapy.Different internal fixators are selected in different studies.However,there are few studies on influential factors for outcomes of internal fixation at present.OBJECTIVE:To investigate related influential factors for outcomes of internal fixation in elderly patients with osteoporotic intertrochanteric fracture.METHODS:A total of 86 elderly patients with osteoporotic intertrochanteric fracture,who were treated in the Guanghua Hospital from May 2011 to May 2014,were enroled in this study.They were divided into three groups according to different manners of fixation.There were dynamic hip screw group (n=34),proximal intramedulary nail group (n=41) and proximal femoral compression plate group (n=11).Rate of fixation failure was compared among the three groups.The relevant factors affecting fixation effects were analyzed using univariate and multivariate analysis.RESULTS AND CONCLUSION:Internal fixation failure was detected in 5 patients (15%) in the dynamic hip screw group,11 patients (26%) in the proximal intramedulary nail group,and 4 patients (36%) in the proximal femoral compression plate group.Results of univariate analysis revealed that Evanse genotyping of patients,whether fractures were found on outer arm side,degree of osteoporosis,quality of reduction,steeple distance,whether combined with internal medicine diseases and selection of fixator were associated with internal fixation effects (P< 0.05).However,the internal fixation effects were not correlated with gender,age,hospital stay and ambulation time (P> 0.05).Multivariate analysis results demonstrated that unstable fractures,severe osteoporosis,fractures of the lateral arm,medical ilness,steeple distance > 25 mm,and different internal fixators are independent factors affecting internal fixation effects in patients.