Comparative Study On ADHLP And DHS Treating Intertrochanteric Femoral Fractures

Objective:Intertrochanteric femoral fracture (IFF) is common in hip fracture and often follows osteoporosis in the aged. There are many methods in treatment of IFF efficacy of which are significantly different. But surgical treatment has been a basic principle in them. Recently, the treatment techniques of IFF are becoming mature with continuously study in biomechanics and improvement of new internal fixation device.Since 1850 s, dynamic hip screw (DHS) has become a standard internal fixation device in treatment of IFF and has been widely used at home and abroad. Anatomical dynamic hip lock plate (ADHLP) is a new type of internal fixation device. From January 2009 to February 2010, we have obtained good achievement by this method. Through retrospective appraisal of operation effect of treatment of IFF, we compare and assess the treatment of IFF by ADHLP and DHS in operative time, blood loss and clinical effect.Methods:Fifty patients with IFF were selected from Department of Orthopedics, Central Hospital of Jilin City, who had been treated by two internal fixation operation (DHS and ADHLP). The data of two groups were collected for statistical analysis on the following aspects:operative time, blood loss, clinical healing time of fracture, postoperative complications and Harris Hip score. The analysis was made with SPSS 13.0.Result:①In DHS group, the operating time was(112.38±8.27)minutes. In ADHLP group, the operating time was (103.42±7.40)minutes. There was significant difference between the two groups (P<0.05). The time of ADHLP group was shorter than that of DHS group.②The intraoperative bleeding was (293.46±7.59)ml in DHS group and was (212.08±7.36)ml in ADHLP group. There was significant difference between the two groups (P<0.05). The average intraoperative bleeding of ADHLP group was less than that of DHS group.③The fracture healing time was (16.50±0.95)weeks in DHS group and was (16.00±0.98)weeks in ADHLP group. There was no significant difference in bone healing time between the two groups (P>0.05).④In DHS group, Harris score was excellent in 13 patients, accounting for 50.0 % and good in 10, accounting for 38.5%. The excellent and good rate was 88.5%; In ADHLP group, Harris score was excellent in 14 patients, accounting for 58.3% and good in 8, accounting for 33.3%. The excellent and good rate was 91.7%;There was significant difference in Harris score between the two groups (P<0.05).Conclusion:①Compared to using DHS, using ADHLP is a short operating time and less bleeding way. The Harris Hip Score of ADHLP group were better than that of DHS group. There were statistical significance in the data of them.②Patients in ADHLP group and DHS group were all found to be healed completely after 9 months of operation, and there was no difference within the two groups. The treatment of intertrochanteric femoral fractures with ADHLP is a effective method worthy of generalizing...