A Clinical Retrospective Analysis Of The Treatment Of Intertrochanteric Femoral Fracture By PFN, Anatomy-special Plate And DHS

Objective: To compare the treatment of intertrochanteric femoral fracture by the fixation of proximal femoral nail (PFN), anatomi-specific plate and dynamic hip screw (DHS), to provide a reference for the fixation's choice and the research of intertrochanteric femoral fracture.Methods: In this study, select the discharged patients with intertrochanteric femoral fracture of the first Clinical Hospital of Jilin University from January 2005 to July 2008 which have a surgery with PFNǐanatomi-specific plate or DHS, rule out the cases with pathological fracture and patients who can not followed up. A total of 62 patients were selected to the final analysis, in which open reduction and anatomy-specific plate fixation in 6 cases, open reduction and DHS fixation in 27 cases, closed or open reduction and PFN fixation with 29 cases. Through access to medical records, telephone follow-up ,review of records, etc., and records the patients age, length of stay, length of surgical incision, operative time, intraoperative blood transfusion ,volume of drainage, compare the relatively good rate of hip function through the post-traumatic hip Sander's score , statistical treatment the records. Results: The age of patients in each group by the rank sum test, anatomy-specific plate group's meta-average 50.5 years old, DHS group 65.0 years old, PFN group 72.0 years old, =7.625, P=0.0221, P<0.05 statistically significant difference. The length of incision of anatomy-specific plate group is on meta-average of 19 cm, DHS group is 15cm, PFN group is 10 cm, by the rank sum test =31.8777, P<0.0001, statistically significant difference. Length of stay in each group, operative time, blood transfusion and drainage, Pvalue>0.05, the difference is not statistically significant. Score of post- traumatic hip functional, anatomy-specific plate group is on average of 57 points, good rate of 100%, DHS group 56 points, 92.3%, PFN group 56 points, 96.6%, =2.4963, P=0.2870, P>0.05, the difference is not statistically significance.Conclusion: This study shows that, by use of PFN, anatomy-specific plate and DHS to treat the intertrochanteric femoral fracture, patients of anatomy- specific plate have the youngest average age, patients of PFN group have the oldest average age. The length of surgical incision in PFN group is superior to the latter two, in length of stay, operative time, intraoperative blood transfusion, postoperative drainage and postoperative functional evaluation was no significant difference between the three. With the aging of the world's popula- tion, to treat the intertrochanteric femoral fracture become more important. It will be a good choice to use anatomy-specific plate and DHS in the treatment of intertrochanteric femoral fracture which have a reasonable indication as their technology is mature. Compared to other methods, PFN is minimally invasive, accord to the principles of human biomechanics, and has advantages in the elder's treatment. PFN is correspond with the future development of intertroc- hanteric femoral fractures'treatment.