The clinical study of the modified Richards nail treating femoral intertrochanteric comminuted fractures / 中华骨科杂志

ABSTRACT

Objective To evaluate the clinical results using modified Richards nail treating femoral intertrochanteric comminuted fractures.Methods From March 2002 to March 2005,69 patients suffered from femoral intertrochanteric comminuted fractures belong to Evan Ⅲ type or Ⅳ type were randomly divided into experimental group and control group.The experimental group was treated with modified Richards nail,including 34 patients,18 males and 16 females.The patients were from 61 to 78 years old,and the mean age was 67.5 years old.In this group,21 patients were involved in left femoral intertrochanteric comminuted fractures,13 patients were involved in right.The pattern of the fractures included EvanⅢ type in 24 cases and Ⅳ type in 10 cases.The control group including 35 patients was treated with DHS,and there were 19 males and 16 females with an average age of 65.9 years(ranged 61 to 80 years).In this group,19 patients were involved in left femoral intertrochanteric comminuted fractures,16 patients were involved in right.The pattern of the fractures included EvanⅢ type in 25 cases and Ⅳ type in 10 cases.Results The experimental group were followed-up 9-23 months with a mean of 11.60?3.78 months.The control group were followed-up 9-24 months with a mean of 11.40?4.12 months.In experimental group,the average fracture healing time was 3.65?0.97 months.While in the control group,the average fracture healing time was 4.32?1.38 months.In experimental group,the leg length measured at the 9th month post-operatively was averagely(0.82?0.36)cm shorter in the diseased side than in the healthy side,while in control group the leg length was averagely(1.08?0.51)cm shorter.There was significant difference between two groups.Compared to the control group,the curative effect was better in the experimental group.Conclusion Treating femoral intertrochanteric comminuted fractures with the modified Richards nail shows a good result,which can effectively diminish the non-union or mal-union of the fractures.