The Effect Of Gamma Nails Treat For The Femoral Intertrochanteric Fractures Of Aged People

【Objective】:To discuss the Gamma nails treat method and efficacy of the femoral intertrochanteric fractures of the aged people.【Methods】:From Jan,2006 to Jan,2008,60 patients(from 60 to 92,mean age71.28) with the femoral intertrochanteric fractures were Gamma nails treated.The patient of males were 31 and females were 29.According to AO classification 31-A1 type of 10 cases,31-A2 type of 44 cases and 31-A3 type of 6 cases.All patients were using Gamma nail fixation,from admission to surgery for 1-5 days(the average of 2.8 days).The cases were followed up for an average of 14 months through X-ray to investigate their fracture healing,functional recovery and analysised therapeutic effect.Assessment of fracture healing according to Harris(Pain,activity,walking ability,daily life and take a total of five indicators).The the ratio of the patients of combined medical disease (diabetes,cardiovascular and cerebrovascular diseases and so on) was 96.67%.For patients with internal diseases combined,comprehensive assessment of physical condition before operative is very impossible.And given active treatment for the cases could not tolerate operation,60 cases of patients with Gamma nail fixation after internal diseases be cured.【Results】:Patients were followed up for 9 to 20 months(the average of 14 months post-operations).Among of 57 patients(1 patient died of pulmonary infection, 1 patient died of myocardial infarction,1 patient lost),there were 49 cases of healed well,4 cases of coxa vara occurred,2 cases out of lag screw cutted by symptomatic treatment and 2 cases of infection,but all patients of 57 were healed well after cured.Reference to Harris hip score(excellent were 15 cases,good were 37 cases can were 3 cases poor were 2 cases),average score from 22.53 to 93.29,the ratio of well was 91.23%.Satisfied with the functional recovery of 57 patients.【Conclusion】:By means of this study,we believed that elderly patients with intertrochanteric fracture often with multiple medical diseases,poor physical condition,and the tolerance of operations was not good.However, the techniques of Gamma nails was simple,with short time,of firm fixation, minimal injury,less bleedings,possibility to do early rehabilitation,less post-operative complications and shorter operative time,with high ratio of bony healing,and improve the ability of self-care.And there were not destroy blood,and would not affect the fracture healing in operation.The ratio of well was 91.23%after Gamma naiis treatment of elderly patients with intertrochanteric fracture.So we considered that it was very suitable for the femoral intertrochanteric fracture of the elderly people,and worthful for recommendation of surgery.