Advanced Research Of Intertrochanteric Fracture

Intertrochanteric fractures are extracapsular fractures of the proximalfemur involving the area between the greater trochanter and lesser trochanter,which accounts for about3.12of total bone fracture, It is becomingincreasingly common as our population ages at the same time their treatmentcosts place great economic strain on society. Therefore, more and moredoctors began to focus on the treatment of intertrochanteric fractures. Theintertrochanteric region is rich in cancellous bone and the elderly are oftenassociated with osteoporosi. Fracture will occure when there is a force appliedto it, However, the intertrochanteric region has an abundant blood supply,which makes fractures in this area much less susceptible to osteonecrosis andnonunion than are femoral neck fractures. There are many classifications usedin clinical, of which AO and Jensen-Evans are the most frequently used,However, most of the classification systems for intertrochanteric fractureshave poor reliability and reproducibility. The stability of the intertrochantericfracture depends on the degree of crushing, two parts fracture is usuallyconsidered stable and three or four parts fracture is considered unstable. Wecan choose surgical or non-surgical treatment. Conservative treatment isaccompanied by serious complications and high risk of mortality. Nonsurgicaltreatment of intertrochanteric hip fractures is usually reserved for patients withcomorbidities that place these patients at unacceptable risk from the surgicalprocedure. Operative treatment is the best option in most cases of hip fracturenow. DHS was suggested as the gold standard for the treatment of stableintertrochanteric fracture, It is seemed intramedullary fixation has moreadvantages when compared with extramedullary fixation, however, there is nooverwhelming proof to prove it. Many patients are suffered from osteoporosis,which makes it diffcult for us to fix it. Therefore, The ideal implant ofintertrochanteric fractures is still debated. With the increasing of the incidence of femoral intertrochanteric fracture, the treatment method is developed. Manynew methods and instruments are used in the surgical treatment ofintertrochanteric fracture. These new instruments have achieved good resultscompared with traditional methods. The indications and advantages as well asdisadvantages of traditional and newly introduced fixative methods andinstruments in the surgical treatment of intertrochanteric hip fractures,such asexternal fixator, Gamma nail, PFN, PFNA, DHS, locking compression plate,InterTan, Fixion PF etc were briefly reviewed in this paper. The recentadvances in the surgical treatment of intertrochanteric fractures were alsoinvolved in the paper. The aim of this review is to provide a reference for theappropriate treatment of Intertrochanteric fractures.