Different Surgical Treatment Of Senile Intertrochanteric Fracture Curative Effect Comparison

Objective:Retrospective analysis of proximal femur anti rotary intramedullary nailing(proximalfemoralnail Anti-rotation PFNA),dynamic hip screw(DHS)and the artificial joint replacement in the treatment of the clinical curative effect of femoral intertrochanteric fracture.In order to provide reference for clinical,better to choose operation method.Methode:Randomly in June 2012 to June 2016 in zibo qi all orthopaedic hospital treated140 cases of elderly femoral intertrochanteric fracture treatment.Aged 63 to 91,the average age of 75.1 years,49 cases of male,female 91 cases.With DHS,artificial femoral head replacement,PFNA treatment,compare the three methods of treatment of incision length,operative time,blood loss during operation,perioperative blood transfusion and postoperative began to load time and postoperative 1 years of hip function(Harris score),and other indicators,using SPSS17.0 software for statistical processing.Results : 140 patients with intertrochanteric fracture of femur were followed up for 7 ~25months according to the random number table method,an average of 14.5 + /-2.2months.DHS group(46): incision length 10 to 16 cm;The operation time of 110.4 + /-25.4 min;Intraoperative hemorrhage of 351 + /-51.2 ml;Perioperative blood transfusion volume 131.5 + /-51.2 ml;Postoperative weight-bearing time 42 ~ 94 days;Postoperative Harris hip score 1 year: 32 cases,10 cases of benign,can be in 2 cases,2cases,was 91.3%.PFNA group(49): incision length 5 ~ 7 cm;The operation time of52.1 + /-15.5 min;Intraoperative hemorrhage of 211 + /-31.4 ml;Perioperative blood transfusion volume 91.2 +/-31.7 ml;Postoperative weight-bearing time 3 ~ 10 days;Postoperative Harris hip score 1 year: 33 cases,13 cases,2 cases,1 case,was 93.8%.The artificial joint replacement group(45): incision length 12 to 18 cm;The operation time of89.2 + /-18.9 min;Intraoperative hemorrhage of 410 + /-81.4 ml;Postoperative weight-bearing time 4 ~ 12 days;Perioperative blood transfusion volume 400.2 + /-35.9ml postoperative Harris hip score: 1 year 30,12 cases,can be in 2 cases,1 case,was93.3%.We compare the above data and statistical analysis hint: three groups on the length of incision and operation time PFNA group compared with the artificial femoral head and DHS group has obvious advantages,the difference had statistical significance(P <0.05).Intraoperative bleeding doesn't accord with normal distribution and variance not neat,so using nonparametric rank and inspection,P < 0.05 so that there are significant differences between the three,two,PFNA group the least amount of blood loss,and the artificial joint group most of the bleeding.Transfusion amount does not conform to the normal distribution and variance not neat,using nonparametric rank and inspection,P <0.05,so there are significant differences between the three,two,artificial joints,compared with other two group blood transfusion amount is much,between the DHS group and PFNA group no difference between the amount of blood transfusion.Postoperative start load time do not accord with normal distribution and variance not neat,using nonparametric rank and inspection,P < 0.05,so there are significant differences between the three,two,DHS group than other two groups of postoperative began to load time is long,no obvious difference was found between PFNA group and artificial joints.Conclusion : Three kinds of technique method for senile femoral intertrochanteric fractures can achieve good curative effect.The DHS group and PFNA group artificial femoral head replacement group,the length of the incision,operative time,blood loss during operation,perioperative blood transfusion and postoperative start load time and other indicators are dominant,PFNA is an ideal choice for the treatment of senile intertrochanteric fracture.