Abstract:

BACKGROUND: The key of intertrochanteric fractures in elderly patients is to select the appropriate fixation, but few clinical studies concerned different fixation methods for blood volume of blood circulation system in elderly patients with intertrochanteric fractures.
OBJECTIVE: To compare the effects of proximal femoral intramedullary nail and dynamic hip screw on blood 
volume of blood circulation system in elderly patients with intertrochanteric fractures.  
METHODS: A total of 48 elderly patients with intertrochanteric fractures, who were treated in the Jiangyin Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from January 2012 to September 2014, were enrolled in this study. These patients were assigned to two groups (n=24). Patients in the observation group received treatment with proximal femoral intramedullary nail, and patients in the control group received treatment with dynamic hip screw. Postoperative blood loss, perioperative blood transfusion, preoperative and 3-day postoperative hemoglobin difference, incidence of postoperative complications, dominant blood loss, and hidden blood loss were compared between the two groups. Range of motion of the hip and Harris score of the hip were compared between the two groups at 4 and 12 months post surgery.
RESULTS AND CONCLUSION: Intraoperative blood loss was less in the observation group than in the control group  (P < 0.05). No significant differences in perioperative blood transfusion and preoperative and 3-day postoperative hemoglobin were detected between the two groups (P > 0.05). The operation time was significantly longer in the observation group than in the control group (P < 0.05). The incidence of postoperative complications was significantly lower in the observation group than in the control group (P < 0.05). No significant difference in length of hospital stay was detected between the two groups (P > 0.05). Within the same time period, the range of motion of the hip and Harris score of the hip were better in the observation group than in the control group (P < 0.05). The total amount of blood loss and dominant blood loss were less in the observation group than in the control group (P < 0.05). These findings indicate that compared with the dynamic hip screw, proximal femoral nail fixation for intertrochanteric fracture has less intraoperative blood loss, lower incidence of postoperative complications, postoperative range of motion of the hip and better hip score. However, operation time of proximal femoral nail was long. There were no significant differences in hemoglobin difference and perioperative blood transfusion between the two fixation methods.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Femoral Fractures, Bone Nails, Blood Loss, Surgical