International Journal of Clinical and Experimental Medical Sciences

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Comparative Analysis of Three Internal Fixation Methods for Intertrochanteric Fracture of Femur in the Elder

Received: 12 January 2020    Accepted: 24 February 2020    Published: 10 March 2020
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Abstract

As the average life span of the Chinese prolongs, the number of intertrochanteric fractures of the femur in elderly patients has increased all the time, and gradually becomes a more common type of fracture in elderly patients. From January 2011 to December 2016, 137 elderly patients with intertrochanteric fractures were treated with 3 mehhods, including locking plate, proximal femoral nail (PFNA) and artificial femoral head replacement. The mean age was 79.16±3.45 years. The mean follow-up time was 17.20±1.30 months. The operative time, intraoperative bleeding volume, postoperative complications, and Harris score of the hip joint at 1 month and 1 year after surgery were compared among the three groups. Statistical analysis by SPSS 22.0 software showed that the operation time of group C was the shortest, followed by group B and group A. The difference was statistically significant (p<0.05). There was no significant difference in operation time between group A and group B (p>0.05); There was no significant difference in bleeding volume between the three groups (p>0.05). Group A had the lowest complication rate, followed by group C and group B. But there was no significant difference between the three groups (X2=0.0618, p>0.05). All the patients were cured and discharged after active symptomatic treatment. Among the patients, the mean Harris score of group A was 38.52±6.51 at 1-month follow up postoperatively; the mean Harris score of group B was 44.28±5.97 at 1-month follow up postoperatively; the mean Harris score of group C was 70.59±6.99 at 1-month follow up postoperatively, the C group was the best and the B group was the second. There was a significant difference between the three groups (p<0.05). The mean Harris score of group A was 84.40±9.34 at 1-year follow up postoperatively; the mean Harris score of group B was 83.12±8.76 at 1-year follow up postoperatively; the mean Harris score of group C was 85.25±8.07 at 1-year follow up postoperatively. There was no significant difference between the three groups (p>0.05). During the follow-up period, there was no loosening or breakage in the internal fixation, and the fracture healed well. This study concluded that locking plate, PFNA or artificial femoral head replacement can achieve satisfactory clinical results in elderly patients with intertrochanteric fractures, but artificial femoral head replacement can achieve early functional recovery, more conducive to elderly patients.

DOI 10.11648/j.ijcems.20200601.12
Published in International Journal of Clinical and Experimental Medical Sciences (Volume 6, Issue 1, January 2020)
Page(s) 5-11
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Intertrochanteric Fractures, Locking Plate, Proximal Femoral Anti-rotation Intramedullary Nail, Artificial Femoral Head Replacement

References
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[3] Banaszkiewicz P A. Traumatic Arthritis of the Hip After Dislocation and Acetabular Fractures: Treatment by Mold Arthroplasty: An End-Result Study Using a New Method of Result Evaluation [M]// Classic Papers in Orthopaedics. Springer London, 2014: 349-362.
[4] Kim J T, Kim H H, Kim J H, et al. Mid-Term Survivals After Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteric Fractures in Elderly Patients. [J]. Journal of Arthroplasty, 2017.
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[6] Aktselis, I., Kokoroghiannis, C., Fragkomichalos, E. et al. Prospective randomised controlled trial of an intramedullary nail versus a sliding hip screw for intertrochanteric fractures of the femur [J]. International Orthopaedics (SICOT) (2014) 38: 155.
[7] C. Rogmark, O. Leonardsson; Hip arthroplasty for the treatment of displaced fractures of the femoral neck in elderly patients [J]. Bone Joint J 2016; 98-B: 291–7.
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[9] Neuman MD, Silber JH, Magaziner JS, Passarella MA, Mehta S, Werner RM. Survival and Functional Outcomes After Hip Fracture Among Nursing Home Residents. JAMA Intern Med. 2014; 174 (8): 1273–1280.
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[12] Roberts K C, Brox W T, Jevsevar D S, et al. Management of hip fractures in the elderly [J]. Journal of the American Academy of Orthopaedic Surgeons, 2015, 23 (2): 131.
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[14] Owsley, Kevin C, Gorczyca, et al. Displacement/Screw Cutout After Open Reduction and Locked Plate Fixation of Humeral Fractures [J]. Jbjs, 2008, 90 (2): 233-240.
[15] Zhang H, Zhu X, Pei G, et al. A retrospective analysis of the InterTan nail and proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures in elderly patients with osteoporosis: a minimum follow-up of 3 years [J]. Journal of Orthopaedic Surgery & Research, 2017, 12 (1): 147.
[16] Lems W F, Dreinhöfer K E, Bischoff-Ferrari H, et al. EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures [J]. Annals of the Rheumatic Diseases, 2017, 76 (5).
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[18] Yu W, Zhang X, Zhu X, et al. Proximal femoral nails anti-rotation versus dynamic hip screws for treatment of stable intertrochanteric femur fractures: an outcome analyses with a minimum 4 years of follow-up [J]. Bmc Musculoskeletal Disorders, 2016, 17 (1): 1-6.
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Author Information
  • Department of Orthopaedics, The People's Hospital of Baiyun District, Guangzhou, China

  • Department of Psychological Rehabilitation, Kunming Special Service Recuperation Center of the Army, Kunming, China

  • The PLA 74th Group Army Hospital, Guangzhou, China

  • The PLA 74th Group Army Hospital, Guangzhou, China

  • The PLA 75th Group Army Hospital, Dali, China

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    Junze Chen, Yanfen Zheng, Yongji Xing, Ye Lin, Wen Zhong. (2020). Comparative Analysis of Three Internal Fixation Methods for Intertrochanteric Fracture of Femur in the Elder. International Journal of Clinical and Experimental Medical Sciences, 6(1), 5-11. https://doi.org/10.11648/j.ijcems.20200601.12

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    ACS Style

    Junze Chen; Yanfen Zheng; Yongji Xing; Ye Lin; Wen Zhong. Comparative Analysis of Three Internal Fixation Methods for Intertrochanteric Fracture of Femur in the Elder. Int. J. Clin. Exp. Med. Sci. 2020, 6(1), 5-11. doi: 10.11648/j.ijcems.20200601.12

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    AMA Style

    Junze Chen, Yanfen Zheng, Yongji Xing, Ye Lin, Wen Zhong. Comparative Analysis of Three Internal Fixation Methods for Intertrochanteric Fracture of Femur in the Elder. Int J Clin Exp Med Sci. 2020;6(1):5-11. doi: 10.11648/j.ijcems.20200601.12

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  • @article{10.11648/j.ijcems.20200601.12,
      author = {Junze Chen and Yanfen Zheng and Yongji Xing and Ye Lin and Wen Zhong},
      title = {Comparative Analysis of Three Internal Fixation Methods for Intertrochanteric Fracture of Femur in the Elder},
      journal = {International Journal of Clinical and Experimental Medical Sciences},
      volume = {6},
      number = {1},
      pages = {5-11},
      doi = {10.11648/j.ijcems.20200601.12},
      url = {https://doi.org/10.11648/j.ijcems.20200601.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijcems.20200601.12},
      abstract = {As the average life span of the Chinese prolongs, the number of intertrochanteric fractures of the femur in elderly patients has increased all the time, and gradually becomes a more common type of fracture in elderly patients. From January 2011 to December 2016, 137 elderly patients with intertrochanteric fractures were treated with 3 mehhods, including locking plate, proximal femoral nail (PFNA) and artificial femoral head replacement. The mean age was 79.16±3.45 years. The mean follow-up time was 17.20±1.30 months. The operative time, intraoperative bleeding volume, postoperative complications, and Harris score of the hip joint at 1 month and 1 year after surgery were compared among the three groups. Statistical analysis by SPSS 22.0 software showed that the operation time of group C was the shortest, followed by group B and group A. The difference was statistically significant (p0.05); There was no significant difference in bleeding volume between the three groups (p>0.05). Group A had the lowest complication rate, followed by group C and group B. But there was no significant difference between the three groups (X2=0.0618, p>0.05). All the patients were cured and discharged after active symptomatic treatment. Among the patients, the mean Harris score of group A was 38.52±6.51 at 1-month follow up postoperatively; the mean Harris score of group B was 44.28±5.97 at 1-month follow up postoperatively; the mean Harris score of group C was 70.59±6.99 at 1-month follow up postoperatively, the C group was the best and the B group was the second. There was a significant difference between the three groups (p0.05). During the follow-up period, there was no loosening or breakage in the internal fixation, and the fracture healed well. This study concluded that locking plate, PFNA or artificial femoral head replacement can achieve satisfactory clinical results in elderly patients with intertrochanteric fractures, but artificial femoral head replacement can achieve early functional recovery, more conducive to elderly patients.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Comparative Analysis of Three Internal Fixation Methods for Intertrochanteric Fracture of Femur in the Elder
    AU  - Junze Chen
    AU  - Yanfen Zheng
    AU  - Yongji Xing
    AU  - Ye Lin
    AU  - Wen Zhong
    Y1  - 2020/03/10
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    N1  - https://doi.org/10.11648/j.ijcems.20200601.12
    DO  - 10.11648/j.ijcems.20200601.12
    T2  - International Journal of Clinical and Experimental Medical Sciences
    JF  - International Journal of Clinical and Experimental Medical Sciences
    JO  - International Journal of Clinical and Experimental Medical Sciences
    SP  - 5
    EP  - 11
    PB  - Science Publishing Group
    SN  - 2469-8032
    UR  - https://doi.org/10.11648/j.ijcems.20200601.12
    AB  - As the average life span of the Chinese prolongs, the number of intertrochanteric fractures of the femur in elderly patients has increased all the time, and gradually becomes a more common type of fracture in elderly patients. From January 2011 to December 2016, 137 elderly patients with intertrochanteric fractures were treated with 3 mehhods, including locking plate, proximal femoral nail (PFNA) and artificial femoral head replacement. The mean age was 79.16±3.45 years. The mean follow-up time was 17.20±1.30 months. The operative time, intraoperative bleeding volume, postoperative complications, and Harris score of the hip joint at 1 month and 1 year after surgery were compared among the three groups. Statistical analysis by SPSS 22.0 software showed that the operation time of group C was the shortest, followed by group B and group A. The difference was statistically significant (p0.05); There was no significant difference in bleeding volume between the three groups (p>0.05). Group A had the lowest complication rate, followed by group C and group B. But there was no significant difference between the three groups (X2=0.0618, p>0.05). All the patients were cured and discharged after active symptomatic treatment. Among the patients, the mean Harris score of group A was 38.52±6.51 at 1-month follow up postoperatively; the mean Harris score of group B was 44.28±5.97 at 1-month follow up postoperatively; the mean Harris score of group C was 70.59±6.99 at 1-month follow up postoperatively, the C group was the best and the B group was the second. There was a significant difference between the three groups (p0.05). During the follow-up period, there was no loosening or breakage in the internal fixation, and the fracture healed well. This study concluded that locking plate, PFNA or artificial femoral head replacement can achieve satisfactory clinical results in elderly patients with intertrochanteric fractures, but artificial femoral head replacement can achieve early functional recovery, more conducive to elderly patients.
    VL  - 6
    IS  - 1
    ER  - 

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