Different Internal Fixation for Intertrochanteric Fractures in Elderly Patients

Objective To compare clinical outcomes of four kinds of internal fixation for intertrochanteric fractures in elderly patients.Methods From March 1999 to May 2009,121 elderly patients with intertrochanteric fractures were treated in our hospital.The surgical procedures included dynamic hip screw(DHS,group A,n=43),percutaneous compression plate(PCCP,group B,n=19),proximal femoral nail(PFN,group C,n=27) and Gamma nail(group D,n=32).The difference of patient age and fracture type in the four groups has no statistical significance(P0.05).The data of operation duration,blood loss,postoperative complications,fracture healing time and postoperative hip function score were used to evaluate the clinical outcome.Results Incisions of patients in all groups were healed without any wound infection.All patients were followed up for 18 to 108 months with an average time of 56.4 months.Group B,C and D had the advantages of shorter operation time,less blood loss,and shorter fracture healing time compared with group A(P0.01),while there was no statistical difference among groups B,C and D in terms of the above indicators(P0.05).The rates of postoperative complications were higher in group A than other groups(P0.05).The postoperative hip function scores were not significantly different among the four groups(P0.05).Conclusions PPCP,Gamma nail and PFN are suitable for elderly patients with intertrochanteric fractures with slight trauma and fewer complications.The fracture reduction and the position of the internal fixation are important.