Three Different Surgical Treatments For Subtrochanteric Fracture Compared

Objective:To explore the dynamic condyle screw (dynamic condyle screw, DCS), Gamma nail (GN), proximal femoral nail (proximal femoral nail, PFN) treatment of different types of subtrochanteric fractures. Methods:The hospital (Shandong University of TCM, First Affiliated Hospital) in the last three years, cases of subtrochanteric fractures, 50 cases of internal fixation in different ways according to DCS is divided into groups, GN group, PFN group. By Seinsheimer typing, II type 3 cases, III A type 15 cases, IV type 17 cases,â…¤type in 15 cases. DCS group of 21 cases. Gamma nail group of 17 cases. PFN group of 12 cases. All patients were followed up for 6 months to 18 months, respectively, from the operative time, blood loss, postoperative complications, postoperative ambulation time, the clinical fracture healing time, postoperative recovery of joint function level abnormal healing, postoperative complications, Harris score, and several other aspects of comparison, the comparative analysis of different surgical methods of treatment. Results:The group of 50 cases, in 3-6 months after film review standards are up to fracture healing, non-hip varus deformity and other complications occurred. DCS, GN in the operative time, blood loss, intraoperative blood transfusion and postoperative hip function no significant difference. PFN compare with the above two sets of operating time, blood loss, intraoperative blood transfusion volumes, more significant differences in postoperative hip function and fracture healing time no significant difference between the three groups. Conclusion:DCS, GN, PFN three kinds of internal fixation methods in the treatment of subtrochanteric fractures have different characteristics, clinical features should be based on the type of fracture, combined with the specific cases, different types of fractures of the strict control of surgical indications, select the correct fixation, in order to ensure surgery. For subtrochanteric fractures near the proximal femur using DCS fixed better. For unstable subtrochanteric fractures, the need of early postoperative weight-bearing persons, should adopt the Gamma nail fixation. PFN intramedullary fixation is a minimally invasive surgery with small incision on the soft tissue injury and is suitable for the elderly.