The Clinical Research And Innovation Of Proximal Femoral Expansive Intramedullary Nailing Treating Intertrochanteric Fracture With Osteoporotic

Experiment 1 :Compareing Fixion PF with PFNA Clinical Treatment In Intertrochanteric Fractures with OsteoporoticObjective: This study aimed to verify the treatment for osteoporosis intertrochanteric fracture with the Fixion PF.Methods: A retrospective clinical study had been done with 29 cases that elderly patients with intertrochanteric fracture surgery in our department patients from January 2012 to May 2014.16 of cases were treated with PFNA and 13 of the cases were treated with Fixion PF。PFNA group includes 16 cases, 7 males and 9 females, aged 67-83 years, averaged 73.7±5.4years of age;and 14 fell injury cases,2 traffic injury cases.According to AOclassification criteria, there were A1 type 3 cases, A2 type 12 cases, A3 type 1 cases,.Fixion PF group includes 13 cases,8 males and 5 females, aged 65-89 years, averaged 77.6±7.2 years of age;and 11 fell injury cases,2 traffic injury cases.According to AO classification criteria, there were A1 type 3 cases, A2 type 9 cases, A3 type 1 cases.Comparison of two groups of the first to walk with crutches, fracture healing time, Harris score, severe postoperative complications.Results: 29 patients were followed, PFNA group was followed up for 24-45 weeks, Fixion PF group was followed up for 21-48 weeks, All fractures were healed;and broken screws,infection,femoral head necrosis did not happen.According to the Harris standard for evaluation,the PFNA group was good rate of 93.7%,averaged 13.6±1.3 weeks of healing time. time to first walk with crutches 3.4±0.5weeks,2 cases occurred DVT,2 cases occurred pulmonary infection,1 case died for for medical disease.the Fixion PF group was good rate of 92.3%,averaged 13.1±1.5weeks of healing time, time to first walk with crutches 3.2±0.7weeks,1 cases occurred DVT, 2 cases occurred urinary system infection, 1 case died for for medical disease.The Harris grade,averaged time of fracture healing,time to first walk with crutches,occurrence rate of serious complication between two groups did not have obviously statistical difference.Conclusions: Fixion PF and PFNA in the treatment of intertrochanteric fractures with osteoporotic effect are the same.Fixion PF and PFNA are all fit for treatment of intertrochanteric fractures with osteoporotic.Experiment 2 The Design and Development of The Mechanical Expansion Proximal Femoral Intramedullary NailObjective: Innovativly development a Proximal femoral intramedullary nailing including propulsion and lift type that made the intertrochanteric fracture with osteoporotic Stablethrough mechanical expansion.Design structure The projects include mechanical expansion hip screw,intramedullary nail,locking screw and the mechanical expansion hip screw incules cannulated hip screw,the soft-core nail hip screw cap.Working principle Push the head of hip screw openning outward by pushing or pulling the inner core nail, support the surrounding sclerotin, significantly improve the fixed force between hip screw and bone interface.Innovations: By opening the distal hip screw expansion the nail compacted the surrounding bone and increased the contacting area with the surrounding bone.The head of hollowing nail was equipped with external thread, increasing the friction between the hip screw and surrounding spongy bone,improving the holding force in proximal femoral hip screw, achieving the purpose of effectively fixed the osteoporotic femoral proximal fractures.