| Intertrochanteric fracture is a common clinical fractures occurred in the elderly, the incidence rate of fracture of the body is 3% to 4%. As the aging of society with the continuous improvement of living standards in China, the incidence of elderly is increasing. The elderly patients is often associated with cerebrovascular disease, hypertension, diabetes and other diseases, long-term conservative treatment, such as skeletal traction that asking the patient in bed for a long time, will bring more complications, morbidity and high mortality. Clinical studies confirmed surgical treatment let patients with early exercise that can reduce the pain, reduce complications and mortality. The surgery of intertrochanteric fractures of elderly is further more difficulty and increased risk, due to high demand for surgery, and offen associated with the medical disorder. This text retrospectively analysis CT 80 normal hip measurements from May 2009 - November 2010 in Hubei Province Chinese Medicine Hospital (Garden Hill School District) and Central Hospital, and understand the femoral head, neck, rough Lung morphology related to each other, which used to guide the new law intraoperative needle into the needle point lead and direction. Through the 80 cases of intertrochanteric fracture of the new law compared with the control group, the new law group reached a satisfactory outcome, not only improve the quality of operation, and reduce the operation time, but also reduce the pam.ObjectiveThat using 80 normal CT measurements to understand hip femoral neck, trochanter morphology related to each other is used to guide clinical application of DHS to determine the direction of needle insertion point, and provide the basis for the new 1 aw, and then applied to 40 patients with intertrochanteric fractures to detect success rate and efficiency of the surgery.MethodsThis text retrospectively analysis 80 patients with normal CT measurements of the hip from May 2009 - November 2010 in Hubei Province Chinese Medicine Hospital (Garden Hill School District) and Central Hospital, and calculate the ratio for statistical testing. Then the study selectes 80 cases of intertrochanteric fracture patients which were divided into 40 patients with the new law (new law guided needle direction and angle of needle) and the control group 40 patients (traditional guided needle direction and needle angle), then make the test analysis and comparison between the two groups Patients in the press operation time, the number in perspective, blood loss. By post-traumatic hip function scores (Sanders) standards (including pain, walk ways and posture, function, muscle strength exercise, daily activities, X-ray assessment of the six items), we assess the fine difference between the three, using X2 test method to assess whether differences among the fine difference is statistically significant, and thus detect success rate and efficiency.ResultsThe ratio of measuring CT is statistically significant, which was applied to 40 patients with intertrochanteric fracture surgery. The two groups were followed up for 1.5 years by the new law both patients and control groups in operation time, fluoroscopy times, blood loss, the results showed (P<0.05) was statistically significant, postoperative function scores (Sanders) results (P> 0.05) was not significant, indicating that the new law operative time, intraoperative radiation times, blood volume than the control group, while two patients were in good functional recovery, no significant difference.ConclusionThe measurements of femoral head and neck CT guide needle implantation, and guide wire position which located at the vertices outside the greater trochanter after femoral shaft under 2cm at 4:6 ratio, and direction of the guide pin is the longitudinal axis of the femoral shaft 135 degrees, and then put into the guide pin in the femoral neck anterior cortical bone of femoral neck and femoral head to the horizontal direction. Such operative techniques and time was significantly shorter in the C-arm fluoroscopy technique,and reduced the number of patients less blood loss, so the clinical results was good. Combined with a comprehensive examination before surgery, and more closely with departments, early postoperative functional exercise and herbal reasonable symptomatic treatment,90% of patients can resume pre-injury ability and daily living. So the guidance of head and neck CT measurements DHS guided intraoperative sentinel needle orientation, steps to streamline operations and improve efficiency in both operations have important clinical significance. |
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