| ObjectiveTo compare and Analysis the clinic effects of the Proximal Femoral Nail Antirotation for Asian(PFNA-Ⅱ)、Gamma Nail、InterTAN Nail in the treatment of femoral intertrochanteric fracture, and to surgical treatment of femoral intertrochanteric fractures provide reference to achieve satisfactory clinical effect. MethodThe researchers chose their 85 research objects from the patients treated in Department of Orthopedic of the First Affiliated Hospital of Zhengzhou University for the femoral intertrochanteric fracture in November 2011 to January 2015 to retrospective analysis. There were 40 females and 45 males, ranging from 40 to 89 years old with an average age of 65.8 years. All of these patients were treated with taking double hip standard is slice and risk of hip side after admission. According to AO Type Systerm, there were 30 cases of A1 type,32 cases of A2 type and 23 cases of type A3. there were 35 cases treated with PFNA-Ⅱ,22 cases treated with Gamma and the other 28 cases treated with InterTAN. All the fractures were fresh,unilateral and closed. The average operation time, intraoperative fluoroscopy times, intraoperative blood loss, the weight loading time, fracture healing time, the complications, postoperative 6 months Harris scoring and postoperative 12 months Harris scoring in three group cases were evaluated and compared. The curative effect was compare and Analysis by eight espects of application of statistical software for treatment the femoral intertrochanteric fracture of three kinds of intrameduallary nail. ResultsAll the operations were smoothly and all cases were followed up for 12-18 months with an average time of 13.1 months and there were no lost follow-up. Comparison of the three groups of patients with the operation time: the averaged operation time was 52.20±12.8min in the PFNA-Ⅱ group, the averaged operation time was76.24±15.3min in the Gamma group, the averaged operation time was 61.23±10.05 min in the InterTAN group, differences of the operation time three groups was statistically significant(P<0.05), the PFNA-Ⅱ group use the shortest time,follow by InterTAN group,the longest time is Gamma group; Comparison of the three groups of patients with the intraoperative fluoroscopy times: the averaged intraoperative fluoroscopy times was8.60±1.1 in the PFNA-Ⅱgroup, the averaged intraoperative fluoroscopy times was12.10±0.80 in the Gamma group, the averaged intraoperative fluoroscopy times was8.40±0.90 in the InterTAN group, differences of the intraoperative fluoroscopy times between the PFNA-Ⅱ、InterTAN groups and Gamma group was statistically significant(P<0.05),but Comparison of the two groups of PFNA-Ⅱand InterTAN, both groups were no significant differences in the intraoperative fluoroscopy times(P>O.05); Comparison of the three groups of patients with the intraoperative blood loss: the averaged intraoperative blood loss was 96.80±58.40 ml in the PFNA-Ⅱ group, the averaged intraoperative blood loss was152.30±108.60 ml in the Gamma group, the averaged intraoperative blood loss was 116.23±43.55 ml in the InterTAN group, differences of the operation time three groups was statistically significant(P<0.05), the PFNA-Ⅱ group of bleeding at least,follow by InterTAN group,the most bleeding is Gamma group; Comparison of the three groups of patients with the fracture healing time,: the averaged fracture healing time was13.40±3.10 week in the PFNA-Ⅱgroup, the averaged fracture healing time was14.20±3.20 week in the Gamma group, the averaged fracture healing time was11.10±2.50 week in the InterTAN group, differences of the fracture healing time between the PFNA-Ⅱ、Gamma groups and InterTAN group was statistically significant(P<0.05), InterTAN group need the shortest time,but Comparison of the two groups of PFNA-Ⅱand Gamma, both groups were no significant differences in the fracture healing time(P>O.05); Comparison of the three groups of patients with the weight loading time: the averaged weight loading time was 41.55±22.52 d in the PFNA-Ⅱ group, the averaged weight loading time was40.89±20.94 d in the Gamma group, the averaged weight loading time was 40.15±28.04 d in the InterTAN group, three groups were no significant differences in the weight loading time(P>O.05); Comparison of the three groups of patients with the postoperative 6 months Harris scoring: differences of the postoperative 6 months Harris scoring between the PFNA-Ⅱ、Gamma groups and InterTAN group was statistically significant(P<0.05), InterTAN group has the highest score, but Comparison of the two groups of PFNA-Ⅱand Gamma, both groups were no significant differences in the postoperative 6 months Harris scoring(P>O.05); Three groups were no significant differences in the postoperative 12 months Harris scoring(P>O.05); Comparison of the three groups of patients with the postoperative complications: there were no patients experienced death, delayed healing, around the head and neck shortening, hip varus, femoral shaft fracture, internal fixation of fracture, internal fixation failure, pulmonary embolism, bedsore and other complications. Three groups were no significant differences in the postoperative complications(P>O.05). Conclusions1. PFNA-II、Gamma and InterTAN intramedullary nail systems are effective treatment for intertrochanteric fracture. The weight loading time, postoperative 12 months Harris scoring and the complications was no significant difference. Three kinds of operation method can be early postoperative weight-bearing exercise, shorten the time of recovery.2. The PFNA- II are better than those of Gamma and InterTAN, mainly reflected in the shorter operation time, less bleeding during the operation; It can also reduce the Second hit caused by surgery for patients. The PFNA- II and InterTAN are better than those of Gamma, mainly reflected in the reducing intraoperative fluoroscopy times, which can reduce radiation hazards for the patients; The InterTAN are better than those of Gamma and PFNA- II, mainly reflected in the shorter fracture healing time, higher postoperative 6 months Harris scoring during the operation;... |
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