Comparison Of The Efficacy Of Three Internal Fixation Methods In The Treatment Of Stable Intertrochanteric Fractures In The Elderly

Objective:To compare and analyze the clinical efficacy of dynamic hip system blade(DHS-B),Gamma3 nail and InterTAN in the treatment of stable intertrochanteric fracture in the elderly,and to provide the basis for the choice of internal fixation in gerontal patients with stable intertrochanteric fracture.Methods:The clinical data of 646 patients with intertrochanteric fracture of femur treated in the Department of Trauma Orthopaedics First Hospital of Jilin University from January 2015 to June 2020 were collected,of which108 patients with stable intertrochanteric fractures of type 31-A1.2 and31-A1.3(AO/OTA-2018)were remained after screening based on the predefined inclusion and exclusion criteria.Patients were divided into three groups according to the different internal fixation methods.There were 34 cases in DHS-B group,41 cases in Gamma3 nail group and 33 cases in InterTAN group.The follow-up period ranged form 6 months to24 months,with an average of 18.7 months.The clinical data of sex,age,body mass index,location,preoperative complications,preoperative ASA risk classification,Singh index,hospitalization time,hospitalization cost,operation time,total perioperative blood loss,blood transfusion rate,fracture healing time,hip joint Harris score and postoperative complication rate were collected and analysed by SPSS 21.0 statistical software.Results:Comparison of hospitalization time,hospitalization cost,operation time,total perioperative blood loss and blood transfusion rate between the three groups were statistically significant(P<0.05).In terms of hospitalization time,Gamma3 nail group was shorter than the other two groups,while InterTAN group and DHS group had no difference.In terms of operation time,Gamma3 nail group and DHS group had no difference,but both were shorter than InterTAN group.In term of hospitalization cost,total perioperative blood loss and blood transfusion rate,DHS-B group was less than the other two groups,while InterTAN group and the Gamma3 nail group had no difference.There was no significant difference between the three groups in preoperative complications,preoperative ASA risk classification,Singh index,fracture healing time,hip Harris score and postoperative complications(P>0.05).Conclusion:1.The application of DHS-B,Gamma3 nail and InterTAN in the treatment of stable intertrochanteric fractures in the elderly can achieve good clinical outcomes.2.For the DHS-B group,the operation time is shorter,the total blood loss in perioperative period,blood transfusion rate and the hospitalization cost are less.It is recommended that gerontal patients with stable intertrochanteric fracture should be treated with DHS-B internal fixation.