Chinese Journal of Tissue Engineering Research ›› 2019, Vol. 23 ›› Issue (12): 1846-1852.doi: 10.3969/j.issn.2095-4344.1122

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Four internal fixation methods of proximal femoral nail, locking compression plate, dynamic hip screw, and Gamma nail for treating senile intertrochanteric fractures  

Huang Weiyan, Peng Jiewei, Wan Ming, Zheng Xiaoming, Wang Kangzhen   

  1. Third Department of Orthopedics, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan 528400, Guangdong Province, China
  • Online:2019-04-28 Published:2019-04-28
  • About author:Huang Weiyan, Attending physician, Third Department of Orthopedics, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan 528400, Guangdong Province, China
  • Supported by:

    the Medical Research Foundation of Guangdong Province, No. A201300361 (to HWY)

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Abstract:

BACKGROUND: The types of complications and recovery of different surgical procedures for intertrochanteric fractures vary. The clinically commonly used internal fixation method lacks a comprehensive summary.

OBJECTIVE: To investigate the effects of proximal femoral nail antirotation, proximal femoral locking compression plate, dynamic hip screw and Gamma nail in the treatment of elderly intertrochanteric fractures.
METHODS: A retrospective analysis of 178 elderly patients with intertrochanteric fractures admitted at Zhongshan Hospital of Traditional Chinese Medicine from March 2014 to March 2017 was performed. The patients were divided into proximal femoral nail group (n=41), proximal femoral locking compression plate group (n=44), dynamic hip screw group (n=48) and Gamma nail group (n=45) according to the internal fixation. The clinical data of patients were collected and arranged, the intraoperative and postoperative conditions were recorded. The recovery of hip joint function, and the occurrence of postoperative complications were observed. The excellent and good rate of postoperative curative effect was compared.
RESULTS AND CONCLUSION: (1) The operation time, incision length, intraoperative blood loss and transfusion in the proximal femoral nail group were significantly lower than those in the other three groups (F=87.741, P=0.000; F=650.796, P=0.000; F=1 890.363, P=0.000; F=452.550, P=0.000). The fracture healing time in the proximal femoral nail group was earlier than that in the other three groups (F=24.731, P=0.000). (2) The incidence of complications in the proximal femoral nail group was significantly lower than that in the proximal femoral locking compression plate group (χ2=4.571, P=0.033), dynamic hip screw group (χ2=3.928, P=0.047), and Gamma nail group (χ2=4.398, P=0.036). (3) The Harris hip scores in the proximal femoral nail group were higher than those in the other three groups (F=24.842, P=0.000), and the excellent and good rate was higher than that in the other three groups (χ2=12.363, P=0.006). (4) In summary, the clinical effects of four internal fixation methods for elderly patients with intertrochanteric fractures are satisfactory. Among them, proximal femoral nail has the advantages of shorter operation time, less intraoperative blood loss, and quicker healing. The postoperative hip joint function recovery is better after using proximal femoral nail antirotation than proximal femoral locking compression plate, dynamic hip screw, and Gamma nail.

Key words: Femoral Fractures, Internal Fixators, Tissue Engineering

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