The Clinic Effect Of Fracture Reduction With Positive Medial Cortical Support In Intertrochanteric Fractures Treated With Inter TAN

[Objective]To analysis the clinical effect of fracture reduction with positive medial cortical support in unstable intertrochanteric fractures treated with inter TAN.[Method]A retrospective analysis was performed of the 68 patients(30 men and 48 women,with an average age of 70.43±6.058 years,range from 61 to 84 years)with unstable intertrochanteric fracture(AO/ATO 31A2)who had been treated with Inter TAN in our department from February 2013 to January 2016.They were classified into three groups including positive medial cortical support(36 cases),neutral medial cortical support(24 cases)and negative medial cortical support(8 cases),according to the relationship between the medial cortex of the proximal head and neck and the medial cortex of the distal femoral shaft on the postoperative standard anterioposterior and lateral X-ray film.The 3 groups were compared in terms of preoperative general clinical data,operation time,blood loss,hospital stay,complications,TAD,postoperative radio graphic femoral neck-shaft angle and neck length,and hip Harris score at 6 months follow-up.[Result]There were no statistical differences between the three groups among patient age,sex ratio,operation time,blood loss,hospital stay and the position of lag screw or helical blade in femoral head(TAD)(P>0.05).Patients in positive medial cortical support reduction group had little loss in neck-shaft angle and neck length at 3 months follow-up(P<0.01),and they had more hip Harris scores and lower rate of complication than negative medial cortical support group(P<0.05)at 6 months follow-up.[conclusion]Fracture reduction with positive medial cortical support can obtain more stable contact between femoral head-neck fragment and femoral shaft,provide good bio-mechanical conditions for fracture healing,and decrease incidence of postoperative complications because of earlier functional exercise.