The Application Of The Lateral Wall Of The Unstable Proximal Femoral Fractures Between Gamma3and Proximal Femoral Plate

Proximal femur fracture is a kind of serious trauma which can pr olong bed time,it can lead to pneumonia,pulmonary embolism even lead to death.Proximal femoral fractures are common in elderly pati ents with osteoporosis or as a result of the traffic accident,falling in jury and other energy factors,the preoperative mortality is higher. As China gradually into aging society and the rapid development of modern civilization,the number of patients with proximal femur fract ure increased significantly.Lateral femoral wall refers to the vastus1ateral is muscle anatomically ridge at the bottom of the femoral lat eral bone cortex.This concept gradually brought to the attention of t he orthopaedic clinic doctors.Early reduction and strong fixation is beneficial to patients early recovery,this is the consensus of orthope dic clinical physicians,but on the choice of intramedullary fixation o-r external fixation remains highlycontroversial.Research purposes:Analyzing the result of Gamma3intramedullary nail and femoral locking plate for lateral femoral wall unstable proximal femoral fractures, and we can provide basis for clinical treatment. Research object and methods:During September2012to July2014in our hospital orthopaedic lateral femoral has45cases, Gamma3has24cases, locking proximal femoral anatomic plate21cases. According to the standard surgery surgical approach. The postoperative use of antibiotics for3to5days. We can remove the drainage tubes in48-72hours if the drainage is less than50ml/d after operation. Gamma3intramedullary treatment group can walk after5-7days, Proximal femoral treatment group allowed to sit up after3days and8～12weeks later can walk incompletely weight, full weight bearing walking after fracture healing. Comparing two kinds of surgical treatment of the operation time, intraoperative blood loss,load time, healing time, reoperation rate, average and postoperative hip joint function score of such confinement.The results of the study:1.The blood loss and operation time in those who did Gamma3intraoperative is less than the femoral plate fixation group, but theX-rayirradiation time is increased significantly2.There are no significant difference between two groups of patien ts in hospitalization time and healing time of fracture.3.Gamma3treatment group and plate fixation group Harris hip scor e is basically the same after one year of the operation.4.The incidence of Gamma3intramedullary treatment group and pl ate fixation group in the postoperative complications of the differen ce is notobvious.Theinternalfixation failure rate is higher in plate fi xation group than Gamma3group.Conclusion:1.Gamma3intramedullary fixation and proximal femoral locking plate fixation can all be used for lateral wall unstable proximal femoral fractures, when we choose the treatment we can according to the specific patient and physician experience the clinical treatment.2.Compared to the proximal femoral locking plate fixation group Gamma3group use shorter operation time, less intraoperative blood loss, but number of intraoperative X-ray irradiation increased significantly, in addition the risk of iatrogenic fractures is greater in Gamma3fixation group.3.The fixation failure rate in the proximal femoral plate fixation group is significantly higher than Gamma3.