InterTan Nail In The Treatment Of Senile Osteoporosis Patients With Intertrochanteric Fracture

Objective:Minor trauma can cause femoral intertrochanteric fracture for elderly patients with osteoporosis. Internal fixation surgery treatment has become mainstream for the type of fracture; all kinds of internal fixation materials have advantages and disadvantages. The InterTAN nail is a kind of commonly used internal fixation material, and there was a lot of literature about its efficacy, but in which no patients with osteoporosis was quantified and included in the sample,and the mean time followed up was about one year. This paper mainly follow-up the patients (aged 60 or above; bone density T value is less than or equal to-2.5) cured by the InterTAN nail about the medium and long term effect, discussing its advantages and disadvantages and comparing the AO group differences in efficacy, for providing reference for clinicians.Methods:61 cases of femoral intertrochanteric fracture (fracture type A1/A2,AO classification)who were treated in XiJing Hospital between January 2010 and February 2015 were collected and analyzed. The situation of patients was followed up, and the Harris score of those cases was evaluated. The cases were divided into simple fracture group (group Al) and comminuted fracture group (group A2) according to AO/ASIF classification, and then divided them into the stable fractures (AO type Al.l A1.2 A1.3 A2.1) and non-stable fractures (AO type A2.2 A2.3) according to the stability of the fracture. The operation time, blood loss, postoperative hip function recoveries was compared between the groups.Results:The operative time of the 61 patients was 34 min-105 min, the mean operative time was 69 min; The blood loss during surgery were 85 mL-350 mL, and the mean blood loss was 186 mL; The length of hospital stay was 4 days-18 days, the median length of hospital stay was 8.7 days; Harris score was 65.9 points to 95.9 points, average 89.9 points. Harris evaluation criteria, excellent:43 cases, good:13 cases, can be:3 cases, poor: 2 cases, excellent and good rate were 91.8%.Early postoperative complications:urinary tract infection in 1 case, Urinary retention in 2 cases, pulmonary infection in 1 case,1 cases of deep vein thrombosis,1 cases of bedsore, Superficial wound infection in 1 cases,1 cases of pulmonary embolism; complications at late stage:8 cases of hip pain and limb shortening in 3 cases,1 case with coxa vara. Compared the intraoperative and postoperative indexes of simple fracture group, comminuted fracture group:there was no significant difference between the comminuted fracture group and simple fracture group in the operation time and postoperative functional recovery, blood loss of the comminuted fracture group in the operation was more than the simple fracture group,there was statistical significance (P= 0.023). There was no significant difference between the stable fractures and non-stable fractures in the operation time,blood loss and postoperative functional recovery.Conclusion:Intertan nail has a better effect for elderly patients with osteoporosis in the treatment of intertrochanteric fractures. For type Al, A2 of the fracture(AO classification),whether it is simple fracture, comminuted fracture or stable fracture and unstable fracture, the long-term effect of Inter TAN intramedullary nail is stable, and it has good effect.