Closed Reduction And Anatomic Locking Plate (LCP) Fixation Of Intertrochanteric Fractures Of The Clinical Research

Objective: As society advances, the arrival of China’s aging population,the elderly intertrochanteric fracture incidence gradually increased，Amongthem, the more common intertrochanteric fractures. Combined with lifestylechanges such as human traffic,intertrochanteric fracture were more and morecomplicated because of high-energy injury etc..Surgery allows the fracture siteto get a good reset, firmly fixed, early ambulation in patients with, promotedthe recovery of limb function,shorten the time in bed to reduce itscomplications caused and lower35%mortality of disease elderly whoassociated with diabetes, hypertension,coronary heart disease,cerebrovascularaccident sequelae.With the new continuous development of internal fixationdevices,how to choose a reasonable internal fixation to treat intertrochantericfractures,improving the therapeutic effect is still one of the topics. Throughclinical research,comparative anatomy of the locking plate (LCP) and thedynamic hip (DHS) within the fixed treatment in elderly intertrochantericfractures,clinical reference for the LCP can be used for the treatment of thesefractures.Methods:Select our department since January2010January2012admitted to the elderly intertrochanteric fracture patients，detailed physicalexamination and imaging studies before surgery, and strictly adhere to theindications for surgery. Inclusion criteria:65-85years old, imaging studiesexist intertrochanteric fractures, closed fresh fractures or time does not exceedone month old fracture, pre-injury limb function is normal,normal erythrocytesedimentation rate, C-reactive protein, bone metabolism and endocrinesystem to be check normal to exclude the possible impact of inflammation andinfection;Exclusion criteria: Less than65years of age or more than85yearsof age,old fracture,pathologic fracture.According to internal fixation in different ways, is divided into the LCP group and DHS group，randomly fromeach group were collected30cases, a total of60patients including33casesof males and27females,age65-85years, mean age75.38±0.86years.Causes:traffic accident injuries in12cases, walk a fall of42cases,6cases ofsprain.Both are fresh fracture.Lower limb function was normal beforeinjury.Follow-up of the above cases, we get an objective evaluation of thepatients in the light of the Harris hip score,and research the difference of theanatomic locking plate (LCP) and the dynamic hip (DHS) fixation in thetreatment of elderly intertrochanteric complex fractures of the functionalrecovery，and application of statistical objective analysis of the results tounderstand the anatomic locking plate (LCP) complex for elderlyintertrochanteric fracture treatment.Results:1.60patients were followed6-23months (mean12.67±0.49months)follow-up.2. LCP group (n=28) once healed,two cases due to premature weight ofbroken plate(Re-line LCP fixed after surgery healing);Once healing of the26cases of the DHS group,1cases of fracture，3cases cut out of the femoralhead.3. Two groups of patients with only a one-time healing the Harris hipscore：LCP28cases average score was85.91±1.26，DHC26cases theaverage score was86.29±1.43，Two sets of ratings for statistical analysis (P>0.05），no significant difference in the effect shows that both restore itsfunction in the treatment of intertrochanteric fractures.4. LCP group none of screws cut out of femoral head, DHS group hadthree cases.5. LCP group and DHS group break off the board rate the results wereanalyzed statistically (P>0.05），the difference is not obvious.Conclusion: Complex fracture closed reduction and anatomic lockingplate (LCP) internal fixation of intertrochanteric can be used as an effectiveinternal fixation in the treatment of intertrochanteric between fracture.DHS single screws for femoral stress caused by the cut out of the femoral head issolved by LCP’s screws to enter the femoral neck.However, all eccentricfixed,side of the stress is large,fracture phenomena still exist.Thereforeimprove patient after review of awareness,and review the results to guidepatients with appropriate functional exercises,to improve the effect ofpostoperative treatment and limb function,can not be ignored.