Treatment Of Reverse Intertrochanteric Fracture Of Femur With Extended Zimmer Natural Nail

Objective:The purpose of this study was to investigate the effect of extended Zimmer Natural Nail(ZNN)in the treatment of reverse oblique intertrochanteric femur fracture.Methods:Retrospective analysis of 23 patients with reverse oblique intertrochanteric femur fracture admitted to our hospital from January 2016 to December 2017.Among 23 intertrochanteric fractures,1 fracture(6.1%)was 31-A3.1,7(31.2%)were 31-A3.2,and 15(62.7%)were 31-A3.3.There are 10 males and 13 females with age range of 46~78 years old,average(69±13)years old.The mechanism of injury was slip and fall in 17 cases,motor vehicle crash in 4 cases,and fall from a height in 2 cases(7%),all of which were the first single closed fractures without serious complications of the blood system and other systems.All of them underwent closed reduction and extended ZNN internal fixation.Results:The operation time was 40~76min,with an average of(56±8)min.The intraoperative blood loss was 95~260ml,average(110.8±52.3)ml.All postoperative patients were followed by 5~14 months.The average follow-up time was(8.2±2.4)months.All patients obtained fracture union without further intervention.The fracture union time was 4~13 months,with an average of(5.76±1.31)months,and 3~9months in the A3.1 or A3.2 group,with an average of(4.92±0.64)months.The limb of one patient was shortened by 0.8cm,but the function was not affected.No complications such as thigh pain,deep venous thrombosis of both extremities,varus deformity of hip and failure of internal fixation occurred in all patients.The mean Harris hip joint function score was(90.65±6.21),(range:73~99),18 cases were excellent,3 good,2 fair,and the rate of excellent and good function was 91.3%.Conclusion:Extended ZNN can effectively treat femoral intertrochanteric fractures with less trauma,better biomechanical characteristics,and more in line with human femoral canal anatomical characteristics,with few complications.