| 0bjective:To compare and discuss the clinical application and effect of anatomic locking compression plate(ALCP) and dynamic hip screw(DHS) in treatment of the femoral intertrochanteric fracture.Methods:Look back to analyse the patients of femoral intertrochanteric fracture cured by surgery in The Second Affiliated Hospital of DaLian Medical University from June, 2006 to June, 2010, Chooses 69 proper patients, male 30 examples,female 39 examples, age from 21 to 102(average 68.7±17.5). All patients were divided into ALCP group and DHS gruop, the patients in the two groups are also divided into stable(31-A1) fracture and unstable(31-A2,A3) fracture. 29 examples in ALCP group, 12 male and 17 female, age from 21 to 102(average 68.7±17.5), stable type 6 examples, ustable type 23 examples; 40 examples in DHS group, 18 male and 22 female, age from 38 to 98(average 70.4±14.3), stable type 7 examples, ustable type 33 examples. All patients was followed-up 6 to 48 months postoperatively, carry on statistics analysis to the patients'incision length, the surgery time, the blood loss in surgery, the fracture healing time, the serious complication and Harris score.Results:Studies the contrast and discover that: 1.In the treatment of the stable(31-A1) femoral intertrochanteric fracture:①the average incision length in ALCP group is 13.3±1.5cm, and DHS group is 12.9±1.7cm, to compare differences, there is no statistical significance(P>0.05);②the average surgery time in ALCP group is 88.3 + 15.4min, and DHS group is 110.7 + 25.4min, to compare differences, there is no statistical significance(P>0.05);③the average blood loss in ALCP group is 191.7±94.5(80-360)ml, and DHS group is 245.7±132.5(100-480)ml, to compare differences, there is no statistical significance(P>0.05);④the average fracture healing time in ALCP group is 10.2±1.8 weeks, and DHS group is 10.4±2.1 weeks, to verify the data, there is no statistical significance(P>0.05);⑤there is no complication in DHS group(7 examples) and ALCP group(6 examples);⑥the average Harris score in ALCP group is 97.5±2.1, excellent rate is 100%, and DHS group is 96.7±3.5, excellent rate is also 100%, to compare differences, there is on statistical significance(P>0.05). 2.①the average incision length in ALCP group is 13.6±1.4cm, and DHS group is 12.9±1.8cm, to compare differences, there is no statistical significance(P>0.05);②the average surgery time in ALCP group is 105.4±13.3min, and DHS group is 119.2±27.1min, to compare differences, there is statistical significance between them(P<0.05);③the average blood loss in ALCP group is 236.5±110.8(80-500)ml, and DHS group is 361.5±247.2 ( 150-1500 ) ml, to compare differences, there has statistical significance(P<0.05);④the average fracture healing time in ALCP group is 10.2±1.8 weeks, and DHS group is 10.4±2.1 weeks, to verify the data, there is no statistical significance(P>0.05);⑤t o test the complication rate in DHS(32.0%) and ALCP(4.5%) withχ~2 test, there has statistical significance(P<0.05);⑥the average Harris score in ALCP group is 89.0±7.3, excellent rate is 86.2%, and DHS group is 81.6±12.5, excellent rate is also 70%, to compare differences, there has statistical significance (P>0.05).Conclusion:The effect of two kinds of internal fixation is approximate in the treatment of 31-A1 stable femoral intertrochanteric fracture, and the two methods are preferred; But in the treatment of 31-A2,A3 unstable fracture, ALCP is better than DHS in the the surgery time, the blood loss in surgery, the serious complication rate and the hip function, so ALCP is preferred. |
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