Explore The Effect Of Use Dynamic Hip Screw With Antirotation Screw Under The "Dual-channel" With The Theory Of Statical And Movemental Combination In The Treatment Of Intertrochanteric Fractures

DHS (Dynamic hip screw), the gold standard for surgical treatment of intertrochanteric fractures,has achieved a satisfactory clinical result, but there are some postoperatived complications,such as hip varus deformity,nail cutting and lower limb shortending.The theory of statical and movemental combination is one of the four guiding principles of the intergrative medicine, the theory used to accelerate fracture healing rate and improved the quality of fracture healing.The author believes that the advantages of the DHS comply with the part of movement of The theory of statical and movemental combination,but the part of static is so relatively weak that the complications have happen. If we add some components, has the statical feature, with the DHS, we shall make the device more effective, and reduce the complications rate.Objective:Based on the theory of statical and movemental combination and distribution characteristics of proximal femoral trabecular bone, to investigate the rationality and superiority clinical effects prefer "dual channel" Dynamic hip screw to the traditional standard dynamic hip screw treatment for intertrochanteric fracture with type31-A1and A2.Materials end Methods:A retrospective study in our hospital and Wuhan General Hospital of Guangzhou Military Region from January2009to January2011,65patients treated for intertrochanteric fractures with type31-A1and A2,30patients treated with standard dynamic hip,35patients with "dual channel" Dynamic hip screw.28males and37females, aged41to88years, mean69.9years.65cases, according to the intertrochanteric fracture AO classification,22cases Al, A2type43cases,10cases of which A1.1, A1.2,8cases,4cases of type A1.3; A2.1, type12cases, A2.2in22cases,9cases of type A2.3. This group of patients is not related to the type A3fractures. This group of patients before surgery treatment had underwent tibial tubercle traction, traction3-6d, an average of4.2d.Before surgery and whole pelvis, all patients were taken hip image, lateral view, taken3days after suffering from hip joint, lateral images, shooting a series of patients after discharge hip review, lateral view until fracture healing. More accurate measurement of fracture healing after surgery and hip screw in the femoral head position, between the collapse of the main fracture fragments, and neck-shaft angle changes. Compared using the Student t test whether statistically significant differences between the two groups.Result:65cases were followed up for9to13months, an average of11months. Block between the two groups in the main fracture and collapse of lower limb shortening was no significant difference in degree, but the nail in the femoral head position and movement of the degree of varus deformity were significantly different, the "dual channel" Dynamic hip screw group of excellent anti-rotation pin over standard dynamic hip screw group.Conclutions:The trabecular bone of proximal femoral biomechanical characteristics of their hip spiral-type arrangement, although the standard dynamic hip screw has hip compression function, but not a single nail implants provide good anti-rotation function, dynamic hip screw with antirotation screw under the "double channel" compared with standard dynamic hip screw treatment for intertrochanteric fracture with type31-A1and A2not only retains the standard power sliding hip compression advantages, and can effectively prevent the nail in the femoral head movement, thus preventing the main nail cut out and varus deformity. It comply with the principle of the theory of statical and movemental combination.It can effectively ruduced the rate of hip varus deformity and nail cutting. It a more effective device than DHS when treated the intertrochanteric fractures.