Clinical Research Of The Treatment To Subtrochanteric Fractures By DHS, PFN And Proximal Femoral Anatomic Plate

Objective:To analyze the clinical results of the treatment of o subtrochanteric fractures by using dynamic hip screw (DHS), proximal femoral nail (PFN) and proximal femoral anatomic plate. Methods:Sixty One cases in this study were subtrochanteric fracture patients from June 2003 to September 2009 in the Shan Dong University of TCM Affilitated Hospital orthopaedics impatient.All the cases were divided into three groups according to different treatment.Twenty patients were treated with DHS, twenty one patients were treated with PFN,and the other twenty patients were treated with proximal femoral anatomic plate. The period of follow-up was between 6 months to 2 years.Comparing and analyzing the time and blood loss during operation,the function of resuming in three groups,and the post-operative occurrence of coxa vara, dealing with statistically and then get the result. Results:Three different surgical operation in the average amount of bleeding, there is a highly significant difference (p<0.01).DHS group compared with the other two groups,with an average operative time was a significant difference(p<0.01),PFN group compared with the other two groups,with an average healing time of fracture of a highly significant difference (p<0.01).Three different surgical methods on postoperative evaluation of hip joint function was no significant difference (p>0.05).PFN group for the prevention of postoperative hip varus formation, compared with the anatomical plate,there is a significant difference (p<0.05).Shows three kinds of surgical method in comparison, PFN group less bleeding, shorter surgical time-consuming, the clinical fracture healing time is short. DHS operative time was long, and bleeding. Anatomical plate operative time was less, but the clinical fracture healing time of the longest, but also easy to form the hip varus.Conclusion:1 PFN surgical trauma and less conducive to fracture healing and complications, suitable for all subtrochanteric fractures, especially in osteoporosis patients and surgery in elderly patients with poor tolerance.2 DHS with good curative effect, but the surgical trauma is relatively large.3 proximal femoral anatomic plate less surgical trauma, but not conducive to fracture healing, but also a higher incidence of coxa vara.