| Objective To compare the clinical results of double plates,DHS and anatomic plate for femoral intertrochanteric fractures.Approach the better internal fixation for the femoral intertrochanteric fractures.Methods From September 2008 to May 2009,following the cases of inclusion and exclusion criteria,patients according to hospital medical record number value divided by 3,remainder 1 were divided into double plates group,the remainder 2 were divided into DHS group,the remainder 0 were divided into anatomical plate group.Collection treatment and follow-up intertrochanteric fractures. All the patients signed the informed consent before treatment.All the three groups of gender, age, medical department diseases and the classification of fracture are collected.Compared three groups of patients with surgical conditions,ineraoperative and postoperative complications,efficacy and fracture healing. Evaluated the hip function with the Harris hip function score.Results 1,Collected 68 cases of intertrochanteric patients,of which double plates(A group: Group of double plates,N=26),DHS(B group:Group of DHS,N=22),anatomic plate(C group:Anatomy plate group,N=20). All the three groups'gender and age were no significant difference in statistical analysis(P>0.05).2, there were different of medical department diseases.In double plates group, there were 8 cases of hypertension,4 cases of diabetes,3 cases of anemia and 3 cases of cardiovascular and cerebrovascular diseases; In DHS group there were 11 cases of hypertension,5 cases of diabetes,2 cases of anemia and 1 case of cardiovascular diseases; In anatomical plate group there were 7 cases of hypertension,3 cases of diabetes mellitus,3 cases of anemia and cardiovascular and cerebrovascular disease in 2 cases.Three groups of patients with medical department disease showed no statistical significant difference(P>0.05).3, The mean operative time in double-plates group was 81.27 minutes, with an average blood loss 380.00ml, mean postoperative drainage was 147.77ml; DHS The mean operative time was 101.00 minutes, with an average blood loss 425.00ml, the average postoperative drainage was 159.71ml; Anatomy plate group:the operative time was 73.43 minutes on average, the average blood loss 226.92ml, the average postoperative drainage was 129.33ml.In the three groups,in which amount of average operation time,blood loss,there was significant difference between A group and B group,and there was significant difference too between C group and B group(P<0.05).In the drain of postoperative,there was no significant difference in the three groups(P>0.05).4, All the cases were followed up for 12-15 months(means 12.97±1.26 months) after operation,without loss followed-up. There were no significant difference in union of fracture time(P>0.05).5,Amount of complications of intraoperative and postoperative,there was significant difference in the three groups(P<0.05). The A group was lower than B group in the complications of postoperative,and the A group was lower than C group in the complications of postoperative.The good rate in A group,B group and C group were 88.50%,86.40% and 80.00%,used the Kruskal-Wallis H check,there was significant difference between A group and C group(P<0.05), but no significant difference between A group and B group(P>0.05).Conclusion Double-plates has low complications of postoperative and more soild fixation for fractures. It reduces the risk of the main nail piercing the femoral head,and makes up the defect,in using the DHS,of treatment for anti-intertrochanteric fractures and the serious comminuted fractures. Also it reduces the rate of postoperation maluntion.So that it is a more reasonable treatment of intertrochanteric fractures of the surgical method. |
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