ABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical effects of proximal femur intramedullary nail (PFNA) in treating intertrochanteric fracture in elderly patients.</p><p><b>METHODS</b>From January,2008 to December,2010,the data of 86 elderly patients (aged, 80 to 93 years) with intertrochanteric fracture who underwent internal fixation were retrospectively analyzed. Of them, 54 patients (22 males and 32 females) were treated with close reduction and PFNA internal fixation(PFNA group),and 32 patients (12 males and 20 females) were treated with open reduction and nail-plate internal fixation (control group). Operation time, volume of blood loss, postoperative complications, time of hospitalization and bone union, hip function were compared between two groups.</p><p><b>RESULTS</b>All patients were followed up more than 2 years. Operation time, volume of blood loss, postoperative complications,time of hospitalization in PFNA group were less than that of control group (P<0.01). There was no significant difference in time of bone union between two groups (P>0.05). According to Harris score to evaluate the function of hip joint, PFNA group was better than that of control group (P<0.01).</p><p><b>CONCLUSION</b>Treatment of elderly patients with intertrochanteric fractures with PFNA internal fixations can obtain satisfactory results, the method is better than that of traditional method.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Follow-Up Studies , Fracture Fixation, Intramedullary , Methods , Hip Fractures , General Surgery , Nails , Recovery of FunctionABSTRACT
<p><b>OBJECTIVE</b>To study the efficacy and safety of multimodal prevention of postoperative venous thromboembolism for hip fractures.</p><p><b>METHODS</b>From March 2009 to July 2011, preoperatively, patients were assigned to two groups on the basis of an assessment of their risk factors. One hundred and twelve patients were considered to be low risk, involving 47 males and 65 females,with an average age of (72.40 +/- 13.29) years ranging from 42 to 88,and were managed with aspirin (100 mg once daily for 14 days) as well as intermittent gasing compression devices. Twenty-six patients were considered to be high risk, involving 12 males and 14 females with an average age of (78.50 +/- 12.76) years ranging from 65 to 84,and were managed with low-molecular-weight heparin (0.4 ml,subcutaneous injection once daily for 14 days) and intermittent gasing compression. All patients were underwent Doppler ultrasonography within 24 hours before hospital discharge. All patients were followed-up for 3 months postoperatively. The incidence of deep venous thrombosis of lower limb, pulmonary embolism, gastrointestinal hemorrhage were recorded.</p><p><b>RESULTS</b>Overall, there were no fatal pulmonary embolism, 1 case of symptomatic pulmonary emboli in low risk group, and none were detected in the high-risk group. Deep venous thrombosis was detected in association with 6 (6.25%) of the 112 procedures in the low-risk group and 2 (7.69%) of the 26 operations in the high-risk group. Paitents were selected in opened reduction and internal fixation, the quantity of bleeding, decrease of hemoglobin, hematoma rate, and gastrointestinal hemorrhage rate of low risk group were (538.10 +/- 390.20) ml, (30 +/- 19) g/L, 0, and 1 (1.03%) respectively; those of the high-risk group were (585.95 +/- 403.96) mL, (32 +/- 20) g/L,1 (4.76%), (4.76%), there were no significant different between the two groups, all P > 0.05.</p><p><b>CONCLUSION</b>There were no statistic significances between the aspirin as well as intermittent gasing compression devices and the low-molecular-weight heparin and intermittent gasing compression in preventing venous thromboembolism (VTE) in postoperative postoperative venous thromboembolism for hip fractures. However, there are potential advantages to reduce complications of bleeding and cardiovascular disease. Multimodal prevention of postoperative venous thromboembolism can protect postoperative patients with hip fractures.</p>