Locking Compression Plate And Dynamic Hip Screw In The Treatment Of Intertrochanteric Fractures In Elderly Patients: A Compairson Of Two Fixation Methods

Objective: With the increase in the number of older age groups ofhuman society,the probability of occurrence of hip frctures aresustained increase in the number of hip fractures worldwide fromwhich die more than700,000each year.While about50%of hipfractures are intertrochanteric fractures,such fracture surgery isthe consensus of the clinicians,but more surgical methods,whichsurgery is controversial.Standardized treatment as one of the meansfor intertrochanteric fracture is Dynamic hip screw fixation,thisstudy by comparing the clinical efficacy of Dynamic hip screw withproximal femoral locking plate in the treatment of cases toinvestigate the proximal femoral locking plate clinical usingvalue.Materials and methods: April2007to February2011,by the inclusion and exclusion criteria secected89cases of intertrochantericfracture patients,divides into the locking compression plate(LCP)and dynamic hip screw(DHS) two groups depending on the internalfixation.Two groups of patients were followed up after surgery,comparing postoperative Harris hip score,complications,fracturehealing time indicators,and analysis of the efficacy of LCP groupand DHS group.Results：In this study,89cases in addition to the DHS group1casesin medical disease12months from the death remaining,88cases werefollowed up for24to41months,with an average of30.6months.1cases of the LCP group postoperative hip varus malunion,non-lockingplate loosening,fracture occurs;the DHS group after nailcutting-out four cases,hip varus malunion two cases,no nail platefracture appears to.LCP group data in terms of surgical incision significantlygreater than the DHS group,the difference between the two groupsby t-test with a statistically significant(P＜0.05),for incision,the DHS group is superior to the LCP group which operativeproficiency greater.The LCP group intraoperative blood loss wassignificantly less than the DHS group,t-test differences betweenthe two groups was statistically significant(P＜0.05),operativetime between the two group of difference by t-test,the difference was not statistically significant(P＞0.05),length of hospital staybetween the two groups were not significantly different(P＞0.05).In weight-bearing ambulation with crutches and fracture healing,the time needed by the LCP group was significantly less than theDHS group,between the two groups differences by the t-test wasstatistically significant(P＜0.05),the LCP group in both superiorto DHS group.The LCP group postoperative complications incidence was2.70%,the DHS group rate was11.54%, by the chi-square test,P＞0.05,so LCP group has lower incidence of postoperativecomplications than DHS group,but can not explain that in thepostoperative the LCP group complications efficacy superior to theDHS group,which may be due to the number of cases are rare in thisstudy.24months after the final score, LCP group has the good rate of91.89%, while DHS group has73.07%,the statistical analysis,thedifference was statistically significant(P＜0.05),description ofthe clinical efficacy of the LCP group superior to DHS group,LCPgroup1patient had hip varus deformity,and the reason is notclear,2cases had poor harris score due to poor postoperativefunctional exercise.The DHS group2patients with hip varusdeformity and the7patients rated general reasons were not ideal functional exercise.In short,compared to the DHS group,LCP grouphas a low incidence of postoperative complications,the hipfunctional recovery of the ideal clinical efficacy.Conclusions:Proximal femoral locking compression plate and dynamichip screw are effective means for the treatment ofintertrochanteric fractures in clinical efficacy with satisfactoryresults.However,the proximal femoral locking compression plate asa new type of internal fixation material has fixed firmly,fewercomplications,hip function recovery ideal,etc.,it is recommendedthat bone fracture comminuted intertrochanteric fracture and TypeA2and A3osteoporotic elderly patients with proximal femorallocking compression plate for treatment instead of dynamic hipscrew.For Type A1and stable fracture of Type A2, proximal femorallocking compression plate or dynamic hip screw treatment canachieve a satisfactory effect.