| Objective:To compare and analyse the clinical efficacy of two internal fixation methods(proximal femal locking compression plate and Gamma nail)in curing intertrochanteric fracture in the elderly.To provide the basis for the clinical selection method of fracture fixation in the treatment of elderly intertrochanteric fracture.Methods: Retrospectively analysis of cases of intertrochanteric fractures in elderly(age>65-year-old)from June 2015 to August 2016.We devided them equally into two groups according to the operation mode,the Proximal Femal Locking Compression Plate(PF-LCP)group and the Gamma Nail group.We compare and analyse each group’s information about the operation condition(including cut length of operation,duration of operation,times of X-ray exposure and blood loss in operation),time to full weight bearing,hospitalization time(including hospitalization time before operation,hospitalization time after operation,and total hospitalization time),hospitalization costs,time to fracture healing,the Harris scores of hip function at 6 months after operation and the postoperative complications(like internal fixation fracture,neck shaft angle loss,screw displacement,screw cutting of femoral head,the distal femoral fractures,coxa varus,nonunion,deep venous thrombosis(DVT),infection and death and so on).Results:(1)There were not significantly different in age,gender,position of fracture,cause of fracture,AO type of fracture,combined disease in both group(p>0.05).(2)The cut length of operation,the duration of operation and the blood loss in operation in the Gamma Nail group were significantly reduced compared to that in PF-LCP Group(p<0.01);but times of X-ray exposure in PF-LCP Group was significantly reduced.(3)The hospitalization time before operation and the hospitalization costs in both group were not significantly different in statistic(p>0.05);but the hospitalization time after operation and total hospitalization time in Gamma Nail Group were shortened compared to the other group(p<0.05).(4)The time to fracture healing and the Harris scores of hip function at 6 months after operation in both group were not significantly different in statistic(p>0.05);but the time about full weight bearing in Gamma Nail Group were shortened compared to the other group(p<0.05).(5)One case with lung embolism caused by DVT,one case with screw cutting of femoral head,two cases with lung infection and one case with coxa varus occurred in PF-LCP Group.One case with lung infection and one case with coxa varus occurred in the Gamma Nail Group.We found no significantly difference in both group in statistic(p>0.05)when compared with each type of postoperative complications.But there were respectively 5 cases with postoperative complications in PF-LCP Group and 3 cases with postoperative complications in Gamma Nail Group,which were significantly different in both group in statistic(p<0.05).Conclusion:(1)Both internal fixation of PF-LCP and Gamma Nail have good curative effect to treat intertrochanteric fracture in elderly patients,but internal fixation of Gamma Nail seems to have less postoperative complications compared to the PF-LCP treatment.(2)When compared to internal fixation of PF-LCP,internal fixation of Gamma Nail has the advantage of minimally invasive surgical operation,short duration of operation,and less blood loss,but has more exposure of X-ray in operation.(3)Internal fixation of Gamma Nail also has the advantage of short hospitalization time,early full weight bearing,and fast recovery comparing to internal fixation of PF-LCP. |
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