Clinical Analysis Of A Fracture Reduction Technique With Positive Support Influence The Curative Effect Of Intertrochanteric Fracture Surgery

Objective : A satisfied reduction before the surgery is so vital important for the curative effect of an surgery with internal fixation as surgery with internal fixation has become a tendency for treating the intertrochanteric fracture.This article aims to analysis how a fracture reduction technique with positive support influence the curative effect of an intertrochanteric fracture surgery.Materials and Methods: We random extract 115 patients with intertrochanteric fracture treated in the second hospital of Dalian medical University No.2 hospital from September 2013 to December 2015.No one cases was with ipsilateral fracture or serious soft tissue injury was chosen.Including 42 cases of males and 73 cases of females with an average age of 67±2.2years(rang 55-74years).The trauma mechanism for 88 cases is carelessly low-power injury(such as fall over oneself doing the house work),while other 27 cases injured by traffic accident.All these people were send to hospital immediately when they hurt.According to the Jensen-Ewans score points(1975),the fracture type contain 38 type ? cases?51 type? cases and 26 type V cases.All of them are unstable.Assessment of osteoporosis by Singh index,23 cases were Grade V,17 casees were Grade ?,31 cases were Grade? and 44 cases were Grade ?.There were only 102 cases took BMD test after their injury and all of them got a lower T value then youths of the same sex.Apparently they were all be diagnosed the serious osteoporosis.There were 88 cases of patients suffer from high blood pressure,97 cases of patients suffer from diabetes,18 cases of patients suffer from cerebrovascular disease,15 cases of patients suffer from lung disease,3 cases of patients suffer from other chronic disease.All of them could walk or motion there knees or hip freely.They were classified into three groups according to the mutual alignment of head-neck fragment and the femoral shaft fragment,including 42 positive cases,35 neutral cases and 38 negative.All of the cases were cured by internal fixation.The patient demographic baseline,postoperative radiographic femoral neck-shaft angle and neck length,rehabilitation progress and functional recovery scores were recorded and statistically compared.Results:There were no statistical differences between the three groups among sex ratio,patient age,osteoporosis Singh index,trauma mechanismpre,pre-fracture score of activity of walking ability,ASA physical risk score,number of underlying disease,fracture reduction quality(Garden alignments)and the position of the helical blade in femoral head(TAD).In follow-up,patients in positive medial cortical support reduction group had little loss in neck-shaft angle and neck length,and got groundwalking much earlier than those in negative reduction group,with good functional outcomes and less hip-thigh pain presence.Conclusion:The reduction technique with positive support is unanatomical.it can prevent the malunion or delayed union cause by excessive traction and unstable reduction.Fracture reduction with positive support,allows limited sliding of the head-neck fragment to contact with the femur shaft and achieve secondary stability,providing a good mechanical environment for fracture healing.