Application Study On DHS And InterTAN In Treatment Of Intertrochanteric Fracture Of Femur Of Elderly

Objective:To compare the clinic effects of 2 internal fixation devices, Dynamic hip screw and InterTAN, in treatment of intertrochanteric fracture of femur of elderly in order to provide evidence for clinical choice.Methods:From June 2007 to May 2009,49 cases of intertrochanteric fractures of femur of elderly were treated with DHS and InterTAN fixation (1 case drop in DHS group,1 case drop in InterTan group).2 different internal fixation devices were statisticlly compared in terms of their surgery time, volume of operative bleeding, hospitalization time, postoperative complications, as well as postoperative recovery in treatment of inter-trochanteric fracture of femur of elderly.22 cases were treated with DHS, 25 cases were treated with InterTAN. Age range is from 71 to 98 years, an average age is 81.7±4.3 years in DHS group, an average age is 81.6±5.8 years in Inter TAN group.The reasons of injury:44 cases were caused by falling down when walking or standing,2 cases were caused by traffic accident,1 case falled down from height. All intertrochanteric fractures were closed fractures. All patients'recovery were evaluated with Harris scores and SF36 scores before operation and postoperative following up. All cases adopt AO classification. At first fractures reduction were obtained, then DHS or InterTAN was implanted in bone.Results:All 47 cases were followed up for an average of 16 months(range,10 to 33months).In DHS group,average operation time is 85.9±29.4min, average volume of operative bleeding is 273.9±174.4ml,3 cases with failed internal fixation are unstable intertrochanteric fracture, rate of internal fixation failure is 13.6%, excellent and fine rates of function is 81.8%. Compared with two treatment groups, the InterTAN group presented better theraeutic effects. In InterTAN group, average operation time is 66.1±21.8min, average volume of operative bleeding is 156.7±107.6ml, rate of internal fixation failure is 0. Its operative time was shorter and volume of operative bleeding was significantly lower, its excellent and fine rates of function is significantly higher than DHS group.Conclusion:DHS can be used for stable intertrochanteric fracture. InterTAN can fix effectly not only stable fracture but also comminuted, multiplexand with osteoporosis of the proximal femoral fractures. Its design conform more biomechanical characteristics of the proximal femur and restore effectly the stability of the proximal femur, so can reduce time in bed, improve qulity of life, reduce mortality and complication. Inter TAN is a kind of effective internal fixation device for the treatment of inter-trochanteric fractures in elderly patients in the current.