Three Kinds Of Internal Fixation Treatment Femoral Trochanter Fracture Biomechanical And Clinical Research

Femoral trochanter fracture of hip fracture under 10% 34%,in the past for the relatively few research under the tuberosity.Increasing with the development of economy,the vehicles,the violence of hip fracture increase gradually,under the tuberosity fracture increased year by year,the study also gradually increase.Under the basic research usually include femoral trochanter of physiological anatomy and biomechanical properties of the internal fixation and internal fixation materials,the interaction of internal fixation and bone research,etc.Clinical research generally includes the choice of internal fixation,the methods of the operation,the reset operation,intraoperative blood loss,and postoperative fracture healing,functional rehabilitation evaluation,fracture and postoperative radiographic assessment.In the field of orthopedics,doctors most pays attention to is the type of internal fixation materials and quality.Because different within the solid.Under the overall femoral trochanter fracture fixation material divided into two categories,intramedullary fixation and external fixation,including pulp external fixation of Proximal femoral anatomic plate is commonly used,Dynamic hip screw(DHS)and Dynamic condylar screw(DCS),Locking compression plate(LCP),etc.,Intramedullary fixation used Gamma Nail,Proximal femoral Nail(PFN),Proximal femoral nail antirotation(PFNA),etc.,some internal fixation materials in the process of clinical inspection,due to its own defects,to be being washed out gradually,now the clinical application is one of the most Dynamic condylar screw(DCS),spin the Proximal femoral nail antirotation(PFNA).By the launch of the latest InterTan intramedullary fixation system has been applied to the treatment.Early many journals and magazines at home and abroad on the femoral trochanter fracture using PFNA,DHS reported clinical effect is more,in rece-nt years,reports the clinical application of DCS,InterTan also increase gradually,but at present about InterTan,PFNA,DCS is applied to three kinds of internal fixation materials femoral trochanter fracture under comprehensive comparative evaluation of clinical reports is less,the biomechanical advantages and disadvantages of the report is more rare.Of three methods for internal fixation,biomechanics and clinical therapeutic effect which cooked slightly,no definite conclusion.Therefore,design the study,from the perspective of biomechanics and clinical point of view,the comprehensive evaluation of three fixed way pros and cons to provide theoretical basis for clinical choice of internal fixation and guidance.The first part Three kinds of internal fixation treatment femoral trochanterfracture biomechanical studyPurpose:By biomechanical experiments to explore the Dynamic condyle screw(DCS),Proximal femoral nail antirotation(PFNA),InterTan under applied to femoral trochanter fracture fixation system of axial compressive and torsional resistance.Methods:54 root length pig femoral specimens made of femoral trochanter fracture under(Seinsheimer points A and B ? ?,?,18 root per type)model,each type of fracture is divided into group A and group B,group C were given after DCS,PFNA,fixed InterTan,axial compression nondestructive experiment,torsion and axial compression damage research.Result:Axial loading nondestructive experiment(the same pressure,displacement of femoral head sink mm):(1)?,? type fractures: A group C,group B is less than group A(P<0.05),group C near and group B(P>0.05);(2)? B: less than group B,group A,group C(P<0.05),group B and group A(P >0.05);Torsion experiment(reverse the same Angle),torque(N,m)three type fractures are: group C than group B(P<0.05)and group B than in group A(P <0.05);Maximum loading,axial loading damage type three fractures are: group C than group B(P<0.05),group B than in group A(P<0.05).Conclusion:Femoral trochanter fracture,InterTan,PFNA axial compressive ability and stability is better than that of DCS,and the axial stability is better than that of PFNA InterTan;Ability to resist torsion,rather than the PFNA InterTan,PFNA is superior to the DCS.Second part Three kinds of internal fixation treatment femoral trochanterfracture clinical comparative studyPurpose:From the perspective of clinical application to explore the Dynamic condyle screw(DCS),Proximal femoral nail antirotation(PFNA),InterTan internal fixation system used in three different ways such as femoral trochanter fracture under the advantages and disadvantages.Methods:From December 2014 to December 2015,baoding second hospital of femoral trochanter fracture patients with 109 cases,using DCS,PFNA,InterTan fixed 47 cases,42 cases,20 cases respectively,their admissions,and postoperative 0.5,1,2,3,6,12 months of follow-up results were statistically analyzed,will start from surgery in patients with surgery(note that is not a time of into the operating room until the end of time,blood loss,length of incision,increase of collection,remove the significant difference,and then calculate the average.The patients with fracture healing time,can turn to completely load time,the 1 year in all kinds of complications(including hip varus,hip joint deformity,fracture internal fixation,etc.),as well as the patient's own feelings(in Harris scoring criteria to evaluate)statistical analysis,remove significant difference.Result:Using Intertan and PFNA fixed the patient's operation time,blood loss,length of incision,fracture healing time,full weight-bearing time average andthe incidence of postoperative complications is less than using DCS fixation of the patients(P<0.05),the use of Intertan and PFNA fixed Harris scores higher than that of using DCS fixation patients(P<0.05);Using Intertan fixation in patients of the incidence of postoperative complications is less than using DCS and PFNA fixation of the patients(P<0.05);Using Intertan fixed Harris scores higher than that of using PFNA fixed patients(P<0.05);Using the Intertan and PFNA fixation in patients of operation time,blood loss,length of incision,fracture healing time,full weight-bearing time average differences have no statistical significance(P>0.05).Conclusion:For the vast majority of femoral trochanter fracture patients use InterTan fixed effect is better than that of PFNA,using PFNA fixed effect is better than that of DCS.