To Compare The Clinical Effection Of Three Kinds Internal Fixation For The Treatment Of Femoral Intertrochanteric Fracture In Old People

Objective:To compare the clinical effect of DHS(dynamic hip screw) 、PFNA(proximal femoral nail antirotation blade)、reversed LISS(less invasive stabilization systems) for treatment of femoral intertrochanteric fracture in old people.Methods:Date of 78 old patients who have femoral intertrochanteric fractures and treated in Yanan university affiliated hospital with DHS 、 PFNA 、 LISS between September, 2012 to March 2014 were retrospectively analyzed. First of all, according to the stability of the fracture divide all the patients into two kinds,stable type fractures(48 cases) and unstable fractures(30 cases), In stable type fractures 15 cases were treated with DHS 19 with PFNA,14 with LISS. In this three group collection all the patients’ operation time, intraoperative blood loss, postoperative hospitalization days, fracture healing time, postoperative first fully load time, Harris hip joint function score after 9 months, statistical analysis of there differences. In unstable type 16 cases were treated with PFNA,15 with LISS. Collection two groups’ operation time, intraoperative blood loss, posto- perative hospitalization days, fracture healing time, postoperative first fully load time, Harris hip joint function score data, statistical analysis of the differences.Results:In Stable fractures DHS’ intraoperative blood loss, operative time,is high than other two groups(P<0.05), LISS and PFNA has no obvious difference in this(P>0.05). The first fully load time PFNA is earlier than other two groups(P<0.05), DHS and LISS group has no significant differences(P>0.05). The patients of this three groups’ postoperative hospitalization days, fracture healing time, postoperative Harris hip function score after 9months showed no obvious difference(P>0.05). Afte fivemonths DHS group has a concurrent case of hip screw through the acetabulum. Unstable type the patients of this two groups’ operation time,intraoperative blood loss, postoperative hospitalization days, 9 months postoperative Harris hip scores showed no significant difference(P>0.05). LISS’fracture healing time、first fully load time is high than PFNA(P<0.05). PFNA group has a hip varus deformity five months after of operation, LISS group concurrent a plate’distal screw fracture after 7 months of the operation.Conclusion: For the stable type DHS、PFNA、LISS is the effective treatment in old patients’ femoral intertrochanteric fracture.but PFNA is the minimally invasive operation device, can provide sufficient biomechanical strength,should be as the preferred, but for severe osteoporosis fracture or greater trochanter fracture piece of free should choose LISS steel plate fixation. 2. For the unstable type of old patients’ femoral intertrochanteric fracture PFNA、LISS is the effectively methods. In view of PFNA’biomechanical advantages should be as the preferred. But for the serious osteoporosis, fracture grinding degree, femoral neck with horizontal splitting, lateral femoral wall fractures we should choose LISS treatment,but choose LISS should delay patients’ land activities time。...