| Purpose: Retrospective analysis of manipulation combined with LCP clinical observa tion of the treatment for femoral intertrochanteric fracture.Material and method: A retrospective study was made on 127 patients with int ertrochanteric fractures treated with " tardy bone consolidation" manual reduction and LCP internal fixation after admission from January 1,2016 to January 1,2017.among them,2 old fractures,1 open fracture,3 patients younger than 60 years old and 9 f ollow-up time were excluded.the remaining 111 patients were included in this study.t here were 56 males and the rest females.the average age of all patients was around70 years.The causes of disease of each patient are also different,including 3 cases o f falling injuries at high altitude,33 cases of car accident injuries,and the most com mon one is falling injuries,with a total of 75 cases.According to ao type,there were33 cases,55 cases and 75 cases in a1,a2 and a3.The perioperative situation of pati ents with three fracture types was compared,and the postoperative complications,func tional recovery and clinical fracture healing time of patients with three fracture types were followed up.Results:1.The average operation time was 51.17 minutes,the average intraoperative blood loss was 487.38 ml,and the average hospitalization time was 15.71 days.2 patients had steel plate fracture after operation,2 patients had cervical screw withdrawal after oper ation.The average healing time of fracture was 5.01 months.The last Harris score wa s 90.36 points.2.There was no significant difference in operation time and average hospitalization day s among the three types of fractures(p > 0.05).The difference in intraoperative blo od loss and blood transfusion volume is statistically significant.the higher the fracture classification,the greater the intraoperative blood loss and blood transfusion volume(p < 0.05).There was significant difference in hemoglobin decline value after operat ion(p < 0.05),and there was significant difference between A1 and A3,A2 and A 3.3.There was significant difference between Harris scores at three months,six months a nd one year after operation(p < 0.05).There was no significant difference among t he three types of fractures in terms of the last Harris score and neck shaft angle(he althy side,postoperative affected side and the last follow-up of the affected side)(p> 0.05).There were statistically significant differences in fracture healing time amon g the three types of fractures(p < 0.05),and there were significant differences bet ween a1 and A3,A2 and A3.4.Harris score for functional recovery of the last hip joint(out of 100 points),excel lent(? 90 points)in 79 cases,good(80-89 points)in 18 cases,general(70-79 points)in 9 cases,poor(< 70 points)in 5 cases,the excellent and good rate was 88.0 %.The postoperative complications(nail withdrawal and fracture of steel plate)are related to the reduction of bone setting technique and the ideal position of the neck nail.Conclusion:1.It is most suitable to treat A1 and A2 femoral intertrochanteric fractures by orthogna thic reduction combined with LCP.Under ideal orthognathic reduction and accurate pla cement of implants,can obtain better clinical effect.2.Intertrochanteric fracture is critical to the success of the bone setting manipulation c ombined with LCP therapy is intraoperative bone setting manipulation is ideal neck sc rew position and postoperative functional exercise time is reasonable3.Manipulative reduction combined with LCP is a method for treatment of fracture of femur in the elderly effectively,has the advantages of simple operation,curative effect,economic burden is relatively low,stable internal fixation,especially suitable for prima ry hospital... |
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