Comparison of the efftec between eccentric fixation and intramedullary fixation for treatment of intertrochanteric fractures / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To compare the efficacy between eccentric fixation and internal fixation for treatment of intertrochanteric fractures of femur,to provide a theoretical basis for the selection of the treatment method of the intertrochanteric fractures of femur.</p><p><b>METHODS</b>From February 2007 to January 2010,82 patients with femoral intertrochanteric fracture were treated by internal fixation including 39 cases of eccentric fixation involving 23 males and 6 females, aged from 41 to 81 years old with an average of (62.68±10.69), using the DHS or proximal femoral locking plate; 43 cases of intramedullary fixation involving 15 males, 28 females,aged from 43 to 78 years old with an average of (62.60±8.37),using PFN or PFNA fixed. The surgical incision length, operative time, blood loss and postoperative Harris score between two groups were compared.</p><p><b>RESULTS</b>The wound of two groups were primary healing without operative complications. All cases received follow-up for an average time of 18.3 months (12 to 28 months). The incision length, operative time and blood loss had a statistically significant difference between two groups (P<0.05). Harris scores of hip joint function at 1 month after operation had statistically significant difference between two groups (P<0.05), and Harris scores at 12 months after operation had no statistical significance difference between two groups. The rate of excellent and good was 89.7% in eccentric fixation group and 90.7% in intramedullary fixation group,the difference was not statistically significant (t=0.0613, P>0.05). In eccentric fixation group, there was 1 case of fracture nonunion with DHS loose and ensuing hip varus deformity. In intramedullary nail fixation group, there was no anti-rotation out,distal intramedullary nail of femoral refracture occurred in 1 case.</p><p><b>CONCLUSION</b>Two treatment methods for the treatment of femoral fractures had a good therapeutic effect,but the intramedullary fixation had shorter operative time and less blood loss than the eccentric fixation,it prior to apply to osteoporosis and unstable femoral intertrochanteric fractures.</p>