Efficacy Comparison Of Inter Tan Nail And The Third Generation Of Gamma Nail In Treatment Of The Elderly Femoral Intertrochanteric Fractures

Objective:To compare the efficacy of intertrochanteric fractures of elders between InterTan Nail(TriGen InterTan Nail, TN) and the Third Generation of Gamma Nail(Third Generation of Gamma Nail, TGN).To summarize the clinical experience of the elderly femoral intertrochanteric fractures and provide reference for operative method choice.Methods:According to the inclusion and exclusion criteria, retrospectively contrast analysis 80 cases of elderly patients with femoral intertrochanteric fracture surgery from June 2013 to March 2015. Among them, 26 cases were used of InterTan nail and 54 cases were used of the third generation of Gamma nail. Two groups of patients in the basic information such as gender, age, fracture type, no statistically significant(P > 0.05). Two groups of patients with perioperative data, postoperative indicators, local and systemic complications after surgery were observed and recorded.All data were used SPSS21.0 statistical software for analysis.Results: All of the patients for more than six months follow-up, with an average follow-up time was 10.2±3.7 months. There was no statistically significance in perioperative blood transfusion volume, hemoglobin numerical changes before and after operation, the length of hospital stay between the two groups(P>0.05).There was no statistically significance in the healing time of fracture and Harris hip score(P>0.05). There was no statistically significance between the two groups of patients with fracture healing time that under Singh index level 4(P>0.05).The operation time,intraoperative fluoroscopy times,intraoperative blood loss of the TGN group was less than the TN group(P<0.05) and there was statistically significant. There was a statistically significance in postoperative thigh pain and proximal femoral length change of TN group than TGN group(P < 0.05).In other postoperative complications, such as hip varus deformity, cutout, screw backup, hip pain,nonunion, bedsore,wound infection,Deep venous thrombosis and pulmonary embolism, there was no statistically significance(P > 0.05).Conclusion:According to the study, two methods of treatment has good clinical efficacy,both are suitable for the treatment of the elderly femoral intertrochanteric fractures. The group of the TN is more suitable for unstable femoral intertrochanteric fractures, especially in patients with osteoporosis, but the TGN group has shorter operation time, fewer of intraoperative fluoroscopy, less intraoperative blood loss.Therefore,the TGN is more suitable for elderly patients underlying internal medical diease and with poor conditions.