Evaluation On Curative Effect Of Two Operative Methods In Treatment Of Senile Intertrochanteric Fracture

Objective: To analyze the clinical and effect of two operation methods in treatment of senile intertrochanteric fracture. Methods: From January 2006 to December 2009, 64 patients with intertrochanteric fracture were treated. Of 64 patients, 12 patients were treated by artificial bipolar femoral head(ABFH group), 52 patients by dynamic hip screw(DHS group). In ABFH group, there were 7 males and 5 females with age of 66 to 94 years. The injury was by tumbling in 11 cases, by accident traffic in 1 case, including 4 cases of typeⅠ,3 cases of typeⅡ, 5 cases of typeⅣaccording to Evans classification. In DHS group, there were 31 males and 21 females with age of 65 to 100 years. The injury was by tumbling in 48 cases, by accident traffic in 4 cases, including 16 cases of typeⅠ,8 cases of typeⅡ, 7 cases of typeⅢand 21 cases of typeⅣaccording to Evans classification. Results: In ABFH group, all incisions healed by first intention. In DHS group, incisions healed by first intention in 46 cases and by second intention in 6 cases. There were no statistical differences in surgery duration and discharging time between two groups(P>0.05).The blood loss in femoral head replacement group was superior over internal fixation group(P<0.05).The patients were followed up from 3 to 23 months (mean, 10 months).The union time of fracture was (7.5±2.5)months in ABFH group and (8.4±2.2) months in DHS group. There was no significant difference in the union time of fracture between two groups (P>0.05).Conclusion: The two operative methods have some their superiority, but the replacement of artificial bipolar femoral head is more suitable for the senile unstable intertrochanteric fracture because of simply procedure, less blood loss and early ambulation.