Comparison Of Effects And Biomechanical Study Of Three Plates To Treat Intertrochanteric Fractures

Objective:Of Proximal femur anatomic locking plate (Proximal femoral anatomic locking plate, PFALP) Percutaneous compression plate (Percutaneous compression will plate, PCCP) and Dynamic hip screw (Dynamic hip screw, DHS), three kinds of pulp external fixation method fixed femoral fracture biomechanical and effects comparison between rotor.Method:Selection of proximal femur mold9root, bone cutting between each specimen taken suitable rotor, analog type A1(AO) femoral fractures between rotor model, root of9femoral specimens were randomly divided into3groups, the first group to proximal femoral locking plate fixation, The second group to PCCP is fixed, the third group of DHS fixation. Under the universal mechanical tester for fracture fixation model of axial compression stress and reverse pressure stress test the stability of fracture internal fixation.Selected femoral intertrochanteric fracture65cases, from2007to2011, which greater than or equal to65years of age, among them28cases with anatomic locking plate, application of PCCP fixed20cases, application of DHS fixation of17cases. This group of male43cases, female22cases;65to91years old, average75.6years.Compare three methods of treatment in incision length, operative time, intraoperative blood loss, postoperative flow and bed time, postoperative complications, postoperative follow-up joint implant, compares the indexes of functional status, etc.Result:Experimental proof load under strain, axial pressure, load under horizontal and vertical displacement of the femoral head, torsional stiffness and failure load on the mechanical properties of anatomic locking plate is superior to the fixed PCCP, PCCP is better than that of DHS fixation.65patients received postoperative follow-up of3to24months (mean13.6). Anatomical steel plate and PCCP operation time, blood loss, hospitalization days, postoperative VAS pain score, postoperative weight-bearing time were better than DHS group, the difference was statistically significant (P<0.05).PCCP group length of incision is superior to the anatomical steel plate and DHS group, compare the difference was statistically significant (P<0.05). Postoperative complications in plants (plants within the femoral head cutting, reduction and loss Angle, loose) anatomy of PCCP and DHS group is obviously better than the steel group. Three kinds of internal fixation of fracture healing time and postoperative function is more1year there was no statistically significant difference (P>0.05).Conclusion:Proximal femoral locking plate has a fixed and reliable, and internal fixation with fewer complications, early weight bearing, as well as good fracture healing, especially for severe comminuted fracture of osteoporosis curative effect is reliable. PCCP fixed method has small trauma, less bleeding, weight early advantage, but for the cases of osteoporosis and fractures smash cases complications and reset lost likely within plants. DHS fixation method, trauma, hemorrhage, intraoperative bone splitting possibility and postoperative complications in plants, reduction and loss of possibility. All three types of plate fixation is an effective method in treatment of femoral fractures between rotor and anatomic locking plate and PCCP fixation method is comparative advantage pulp external fixation method.