To Contrast The Therapeutic Effect Of Different Internal Fixations On Senile Femoral Intertrochanteric Fractures

Objective:To compare the treatment of intertrochanteric femoral fractures in the elderly by the fixation of dynamic hip screw(DHS), proximal femoral anatomical plate and proximal femoral nail anti-rotation (PFNA) and study the internal fixation of intertrochanteric femoral fractures in the elderly patients.Methods:Sixty four cases with intertrochanteric femoral fractures from March 2005 to October 2009 in our hospital were divided to three groups, According to the different indications. All patients were at the age of sixty nine to eighty eight. Twenty five cases were male and thirty nine cases were female. All cases were typed in accordance with Tronzo-Evans classification. The group with the treatment of DHS include two cases of type I, sixteen cass of typeâ…¡, fifteen cases of typeIII,six cases of typeâ…£. The group with the treatment of anatomical plate include nine cases of typeIII,six cases of typeâ…£,five cases of typeâ…¤. The group with the treatment of PFNA included two cases of type III,two cases of type IV,one case of typeâ…¤.Recorded the operative time, blood loss during the operation, Weight-bearing time, fracture healing time, operative complications and All cases would be graded by Harris standards after operation.Results:There were no significant differences in blood loss during the operation,Weight-bearing time,fracture healing time,operative complica-tions between the group of DHS and the group of anatomical plate (P>0.05).The operative time with the treatment of DHS was shorter than that of anatomical plate group (P<0.05).When scored by Harris standards, there was a significant difference between DHS group and anatomical plate group (P<0.05). There were no significant differences in operative time, operative complications and fracture healing time between the DHS group and PFNA group (P>0.05).The blood loss during the operation with the the treatment of fixation PFNA was less than that of DHS group (P<0.01) and the Weight-bearing time of the PFNA group was earlier than that of the DHS group (P<0.01).There was no significant difference in Harris hip score of one year after operation. There were no significant differences in fracture healing time between the group of anatomical plate and the group of PFNA (P>0.05). There were significant differences in blood loss during the operation and Weight-bearing time Between them (P<0.01). There were significant differences in Operative time between the DHS group and PFNA group (P<0.05). There were no significant differences between the group of DHS and the group of PFNA when scored by Harris standards (P>0.05).Conclusions:DHS, proximal femoral anatomical plate and PFNA all could be used for intertrochanteric femoral fracture in the elderly and we should choose the best ways according to different types and different patients.We preferred the internal fixation of DHS when we deal with the intertrochanteric femoral fracture of type I and typeâ…¡. Proximal femoral anatomical plates were often used for the intertrochanteric femoral fracture of typeIII,typeIV and type V.The fixation of PFNA was minimally invasive, according to the principles of human biomechanics, and has extensive indications in the elder's treatment. PFNA correspond with the future development of intertrochanteric femoral fractures'treatment.