Double-Claw Plate For The Treatment Of Intertrochanteric Fracture: Fondamental Research And Clinical Application

Objective To study proximal femoral anatomical characteristics as basis , to design a new internal fixation devices—double-claw plate for intertrochanteric femoral fractures, and then to study its anatomical characteristics ,biomechanics,clinical application, so as to provide a theoretical basis for clinical spreading.Materials and Methods 120 adult femur specimens(60 pairs)is selected in Chongqing (from Department of Anatomy of Third Military Medical University and Department of Anatomy of Chongqing Medical University ). Rule out the specimen of a history of bone disease or fracture. Measure a series of intertrochanteric anatomical index,and then apply SPSS 11.0 statistical software to deal with the data, and regression and correlation analysis is also included. P <0.05 indicaates statistical significace . Finally, summarize the previous data and draw the anatomy morphology and bone characteristics of proximal femur .Base on the above data, a new internal fixation devices - double-claw plate(DCP) (China Patent No.ZL98 2 28837.9) for intertrochanteric femoral fractures is designed Its material is 317-L stainless steel with a thickness of 3.5mm, and a flat-shaped double hook shape which is catering to the lateral femoral proximal anatomy curve. For femoral greater trochanter arc-length varies vastly, DCP is classified into three types as large ,medium and small .Of 120 specimens , rule out the obvious osteoporosis by X-ray and bone mineral density in CT ,remaining 30 specimens were randomly divided into 3 groups, EvansⅠ,Ⅱ,Ⅲ, reverse type of intertrochanteric fracture is made manually.Each group is fixed with DCP, DHS, PFAP accordingly( all 317L stainless steel), bio-mechanical test is then carried out to compare the stability of each group.1992.10 ~ 2007.12, we carried out DCP clinical trials【No. 03054 (State Drug Administration Medical Devices Division)】on 145 cases of surgical treatment of intertrochanteric fracture to testify DCP's clinical safety and promotion value.Results①.Anatomical index of the anatomy of femur intertrochanteric department accorded with the normal distribution, there is a line regression relation between the total femur length and femoral head-neck axis length ,as well as neck smallest diameter. DCP's shpae patterns are in good agreement with the femur intertrochanteric department .②.DCP's biomechanical stability is as well as DHS,and is superior proximal femoral anatomical plate .③.DCP for the treatment of intertrochanteric fracture has the advantages of less trauma ,satisfactory biomechanical stability , and could satisfy the intertrochanteric fracture treatment needs.Conclusion The study shows that DCP has the advantages of in good accordence with the femur intertrochanteric segment shpae, biochemicaly stability, satisfactory clinical outcome.DCP could meet the treatment needs of every type of intertrochanteric fracture, and also could meet the treatment needs of osteoporosis cases and Comminuted fracture cases.In particular, DCP could promote to grass-roots level because of its cheapness.