Treatment Of Elderly Patients With Unstable Between The Trochanter Fracture By Anatomic Locking Plate: The Experience And Lesson During Between The Trochanter Fracture

The objective of this master thesis is to get some experience and lessons for the treatment of elderly patients with unstable Between the trochanter fracture by the analysis of anatomic locking plate. The main method is retrospective analysis of using anatomical locking plate fixation(lag screws or steel wire cerclage) plus auxiliary between January 2011 and May 2014 in our hospital. These samples include 36 patients with senile unstable intertrochanteric fractures. For patients with severe osteoporosis(18 cases), anti osteoporosis drug treatment was applied. 11 of these patients were treated by taking the femoral head and neck nail tract filling pressure of mixed planting bone. 44 cases were selected using a simple locking plate in the treatment of patients for comparison. Total 80 patients were followed up. The follow-up time is not less than 6 months, and 3 months before the monthly the patients were visited at least one time. P is larger than 0.05 during the comparison of 6 months after surgery functional scores in the aspects of age, sex, baseline data on postoperative incidence of screw loosening, chronic complications. The difference is insignificantly statistically. P is less than 0.05 during f the amount of auxiliary fixed group of shorter operation time, less bleeding during the operation time and intraoperative bleeding during the operation. In the case, the difference has statistical significance. Judging from the immediate postoperative period and after 3-months follow-up imaging contrast, angle lost in the auxiliary fixing group than in the control group and less length of the femoral neck and neck stem, the comparison between the two has P less than 0.05. Thus, the difference was statistically significant between two groups. P is also less than 0.05 after 3 months postoperative function score. This was statistical difference. The control group had 4 cases of hypostatic pneumonia, auxiliary fixation group of 3 patients, and two groups occur in one case with hip pressure sores and deep venous thrombosis after treatment were cured. The experimental group had one case of femoral neck screw loosening, the control group had nine cases, including fixed plate in one case of fracture, hip varus. Good curative effect is important to obtain later after artificial femoral head replacement. The conclusions include that(1) repair and reconstruction of the medial cortex of senile unstable between the trochanter fracture of femur with structure and mechanics, is conducive to fracture healing, reduce broken nails, broken boards;(2) for patients with severe osteoporosis, the holding force of the screw can be effectively increased through the femoral head and neck nail tract filling mix impaction bone grafting, anti osteoporosis therapy; and(3) elderly patients with unstable between the trochanter fracture should keep the morning exercises and the principle of next night to weight, which is conducive to reduce the occurrence of internal fixation failure.