Retrospective Analysis Of Different Surgical Methods To The Treatment Of Intertrochanteric Fracture In The Elderly

Objectve: To retrospective analyze clinical effect for treating senile intertrochanteric fracture using different methods including proximal femoral nail anti-rotation(PFNA),anatomic proximal femoral locking plate(ALP) and Inter TAN.Method: 120 patients with intertrochanteric fractures from June 2012 to December 2015 in Han-ting People’s Hospital,Wei-fang were analyzed retrospectively,including 76 cases for the left and 44 cases for the right,All cases were divided into A1(14 cases),A2(85 cases)and A3(21 cases) according to AO classification. PFNA, Inter Tan and ALP were used in closed reduction and internal fixation treatment respectively.The indices including incision length, operation time, blood loss, perioperative complications, fracture healing time,weight-bearing time and postoperative hip function(Harris score) were compared,using SPSS17.0 software for statistical analysis.Results : 120 patients were followed up for 12 to 24 months,average of 15.8±3.2months. ALP group( 22cases) :incision length 11 ~ 15cm;operative time90~150min;blood loss was 150~500ml;postoperative drainage 150~342ml; postoperative weight-bearing time 9~16weeks;fracture healing time l2~18weeks; 1 year after Harris hip score:Excellent in 12 cases,good in 6 cases,medium 2 cases,and poor 2 cases,good rate of81.8%.PFNA group(60 cases: Incision length of 5~7cm;operation time 50~90min;blood loss was 100~250ml;postoperative weight-bearing time 2~4weeks;fracture healing time10~13 weeks;1 year after Harris hip score:Excellent in 33 cases,good in 24 cases,medium 3cases,and poor 0 cases,good rate of 93.3%.Inter TAN group(38 cases):incision length of6~9cm;operation time 60~100min;blood loss was 100~300ml;postoperative weight- bearing time 3~7weeks;fracture healing time 12~14 weeks;1 year after Harris hip score:Excellent in25 cases,good in 11 cases,medium 1 cases,and poor 1cases,good rate of 94.7%. the result show that Inter Tan and PFNA have the better treatment effect with less trauma,less bleeding,stable fixation, shorter time of facture healing than the ALP. And the difference between two group have the Statistical significance(P<0.05).The difference of Harris hip score haven’t the Statistical significance in three group.Conclusion: PFNA and Inter Tan treatment of intertrochanteric femoral fractures with less trauma,less bleeding,stable fixation, shorter time of facture healing than the ALP. PFNA and Inter Tan have no significant difference in the above aspects, but their design is resonable and has their own advantages.